ABSTRACT
Objective:To study the expression and significance of neutrophil extracellular traps (NETs) in neonatal sepsis.Methods:Prospective research were used in this study. Term infants with neonatal sepsis hospitalized for the first time in the Department of Neonatology, Children's Hospital of Soochow University from June 2020 to November 2020 were selected as the sepsis group. According to a ratio of about 1∶1, term infants with mild hyperbilirubinemia who were admitted in the same period, with gestational age difference less than 1 week from those in the sepsis group, and whose parents agreed to participate in the study were selected as the control group. On admission, clinical data as well as blood samples of the two groups were collected. Levels of NETs marker citrulline histone H3-DNA (CitH3-DNA) were detected by Enzyme-linked immunosorbent assay, and circulating cell-free DNA (cfDNA) was tested by the fluorescence microplate reader. General data, white blood cell (WBC), neutrophil count (NE), platelet (PLT), C- reactive protein (CRP), blood culture, CitH3-DNA and cfDNA were compared between the two groups. The diagnostic value of CITH3-DNA and cfDNA in neonatal septicemia was analyzed by the receiver operating characteristic (ROC) curve.Results:A total of 74 infants were included in the study, including 39 cases in the sepsis group and 35 cases in the control group. CitH3-DNA and cfDNA in the sepsis group were significantly higher than those in the control group [CitH3-DNA (optical density): 0.85±0.05 vs. 0.48±0.03, cfDNA (mg/L): 0.90±0.05 vs. 0.56±0.03] ( P<0.01). There was no significant correlation between CitH3-DNA and cfDNA. The level of CitH3-DNA had no correlation with gender, gestational age, age, birth weight, WBC, NE, PLT and CRP ( P>0.05). cfDNA was positively correlated with age and NE ( P<0.05), and negatively correlated with PLT ( P<0.05). Combined with CRP, the area under the ROC curve of CitH3-DNA+CRP, cfDNA+CRP, and CitH3-DNA+cfDNA+CRP were 0.947, 0.947 and 0.970 respectively, and the sensitivity to predict neonatal sepsis were 92.3%, 84.6% and 94.9% respectively, the specificity were 94.3%, 97.1% and 100% respectively, all higher than the predictive value of each index alone. Conclusions:The plasma NETs levels increase significantly in neonatal sepsis patients, especially CitH3-DNA with a strong specificity, and can be considered as a biomarker for early diagnosis of neonatal sepsis. NETs together with CRP, could drastically improve the predictive value of neonatal sepsis.
ABSTRACT
BACKGROUND:IPS e. max Press porcelain crown has been widely used in clinical restoration because of its aesthetic effect and biological properties. OBJECTIVE:To explore the effect of IPS e. max Press porcelain crown in esthetic restoration of anterior teeth in terms of marginal adaptation and color match. METHODS:Total y 52 patients with 138 defective anterior teeth (20 males and 32 females, 18-45 years old, including 62 anterior tooth defects, 46 tooth traumas, 30 denticles) were divided into two groups randomly:treatment group (26 cases) and control group (26 cases) were given IPS e.max Press porcelain crown and conditional Co-Cr al oy handcuffed ceramic crowns, respectively. Al the cases were asked for a second visit in 1 week after restoration, and the integrity of ceramic veneer, marginal adaptation, gingival health and color match were evaluated during 6-month and 2-year fol ow-ups. RESULTS AND CONCLUSION:The degrees of satisfaction on the color, shape and adaptation in the treatment group were al higher than those in the control group (P<0.05). At 6 months after restoration, the marginal adaptation, gingival health and color match in the treatment group were al better than those in the control group (P<0.05). At 2 years after restoration, there was also a significant difference in the marginal adaptation, gingival health and color match between the two groups (P<0.05). IPS e.max Press porcelain crown has the advantages of aesthetics and biological characteristics, so it can be used as an ideal restoration method for esthetic restoration of anterior teeth.