Progress in RNA-targeting and Gene Editing Therapies for Transthyretin Amyloidosis Cardiomyopathy / 罕见病研究

Transthyretin(TTR) protein is a tetramer protein, synthesized mainly by the liver. TTR can be misfolded and deposited as amyloid fibrilae and deposited in the myocardial interstroma leading to transthyroxin amyloidosis cardiomyopathy (ATTR-CM). ATTR-CM was included in China's First List of Rare Diseases. Therapeutic strategies for ATTR-CM include blocking TTR synthesis in the liver, stabilizing TTR tetramers and destroying TTR fibra. Small molecule drugs such as tafamidis and diflunisal offer new treatment options for patients. Chlorobenzolic acid became the first drug approved by the U.S. Food and Drug Administration for the treatment of ATTR-CM. Small interfering RNA(siRNA)patisiran and antisense oligonucleotide (ASO)inotersen block TTR expression in the liver and have been approved for the treatment of ATTR variant polyneuropathy (ATTRv-PN)and are in phase Ⅲ trials for the treatment of ATTR-CM. Other siRNA drugs, vutrisiran, and ASO, eplontersen, are being evaluated for clinical efficacy. This article reviews the development of RNA-targeted therapeutics and gene-editing drugs using CRISPR-Cas9.

A study on the conversion of prescribed dose for radiotherapy of logistic nanodosimetry model and microdosimetric kinetic model based on gamma analysis / 中华放射肿瘤学杂志

Objective:To validate the feasibility of the gamma analysis method in the study of prescription dose conversion between logistic nanodosimetry model (LNDM) and microdosimetric kinetic model (MKM) basing on the Chinese self-developed model LNDM by applying clinical experiences of National Institute of Radiological Science (NIRS).Methods:Physical dose distributions derived from the MKM- and LNDM-based carbon ion treatment plans were compared via the method of gamma analysis under the open-source treatment planning platform matRad. In this way, the prescribed dose conversion factor between the MKM- and LNDM-based treatment plans was obtained. Using water phantoms, the influence of geometric shape, size, depth of target volume (TV), prescribed dose and field setting on the conversion factor was investigated comprehensively. Moreover, preliminary verification of the acquired conversion factor was conducted on the C-shape model and a case of liver cancer patient.Results:The conversion factor depended on the field setting rather than the TV shape. Under the condition of single field, the conversion factor was positively correlated with the size and depth of TV, and the prescribed dose. Moreover, the conversion factor was successfully verified using the C-shape model and the patient with liver cancer, where the gamma passing rates (2%/2 mm) of the physical dose distribution generated by the MKM and LNDM treatment plans were 92.79% and 91.19%, respectively.Conclusions:The conversion factors (f=D LNDM/D MKM) obtained in this study might provide guidance for the prescribed dose setting during the carbon ion treatment planning based on the LNDM. Besides, the gamma analysis method could be used for the study of the prescribed dose conversion between different models.

Trend analysis and prediction of accidental fall-related mortality among the elderly in China / 中华创伤杂志

Objective:To analyze the mortality of accidental falls among the elderly in China from 2004 to 2019 and predict the standardized mortality from 2020 to 2024, so as to provide scientific evidence for formulating strategies to prevent accidental falls among the elderly.Methods:The death data of accidental falls of the elderly in China from 2004 to 2019 were collected from the China Death Cause Monitoring Data Set, and the total number of deaths, mortality rate and standardized mortality rate in the elderly from 2004 to 2019 and those data among them of different genders, residences and age groups were calculated. Joinpoint 4.8.0.1 statistical software was used to calculate the annual percent change (APC) and average annual percent change (AAPC) of standardized mortality. The Autoregressive Integrated Moving Average Model (ARIMA) was used to predict the standardized mortality rate of accidental falls among the elderly in China from 2020 to 2024. Results:The number of deaths related to accidental falls among the elderly in China was increased from 2 908 in 2004 to 23 709 in 2019. The mortality rate was increased from 51.89/100 000 in 2004 to 67.74/100 000 in 2019. The standardized mortality rate of accidental falls showed an overall upward trend from 2004 to 2019 (AAPC=1.65, P>0.05), including an upward trend from 2004 to 2010 (APC=1.66, P>0.05), a downward trend from 2010 to 2013 (APC=-9.67, P>0.05), and another upward trend from 2013 to 2019 (APC=7.83, P<0.01). The number of death and mortality rate related to accidental falls in Chinese elderly males and females both showed upward trends from 2004 to 2019, and the standardized mortality rate also showed upward trends from 2004 to 2019 (AAPC males=2.19, AAPC females=0.29, all P>0.05). The standardized mortality rate in males was generally higher than that in females, with that of males showing an upward trend from 2013 to 2019 (APC=7.36, P<0.05) and that of female showing an upward trend from 2014 to2019 (APC=6.92, P>0.05). The number of deaths and mortality rate among the elderly living in rural and urban areas both showed upward trends from 2004 to 2019, and the standardized mortality rate also showed an upward trend from 2004 to 2019 (AAPC rural = 1.71, AAPC urban =1.00, all P>0.05). The standardized mortality rate among the elderly living in rural areas was generally higher than that in urban areas. The rural and urban elderly both showed upward trends from 2013 to 2019 (APC rural = 8.24, APC urban =6.11, all P<0.05). The number of death and mortality rate of different age groups all showed upward trends from 2004 to 2019. The standardized mortality rates of the elderly aged 65-74 years and ≥85 years also showed upward trends from 2004 to 2019 (AAPC 65-74 years=0.38, AAPC ≥ 85 years=4.09, all P>0.05). The standardized mortality rate of the elderly aged 75-84 years showed a downward trend from 2004 to 2019 (AAPC=-0.10, P>0.05), and that of the elderly aged 65-74 years showed an upward trend from 2010 to 2019 (APC=5.35, P<0.05). The standardized mortality rate of the elderly aged 75-84 years and ≥85 years showed upward trends from 2013 to 2019 (APC 75-84 years=6.49, APC ≥ 85 years=10.47, all P<0.05). The ARIMA prediction results showed that the overall standardized mortality rates of accidental falls in the elderly in China from 2020 to 2024 were 69.11/100 000, 72.33/100 000, 74.41/100 000, 76.34/100 000, and 76.48/100 000, respectively, showing a slow upward trend. Conclusions:The accidental fall-related mortality among the elderly in China showed an overall upward trend from 2004 to 2019, and the standardized mortality rate from 2020 to 2024 also shows an upward trend. The elderly who are male in gender, live in rural areas, or at age of ≥85 years are the key population for prevention and control of accidental fall. Active and effective measures should be taken to reduce accidental falls in the elderly so as to contribute to active and healthy aging.

Correlation of short diameter of residual lymph nodes with efficacy and prognosis in esophageal squamous cell carcinoma patients undergoing chemoradiotherapy and establishment of a Nomogram model / 中华放射肿瘤学杂志

Objective:To analyze the correlation of the short diameter of residual lymph nodes with the efficacy and prognosis of patients with esophageal squamous cell carcinoma (ESCC) undergoing chemoradiotherapy (CRT), and establish a Nomogram prediction model to predict the prognosis of ESCC patients.Methods:Clinical data of 143 ESCC patients who underwent CRT in Second People′s Hospital of Huai′an from August 2018 to September 2020 were collected. The survival analysis was conducted with Kaplan- Meier method, log-rank test and univariate prognostic analysis. Multivariate prognostic analysis was performed with Cox models. Finally, a Nomogram prediction model was established to predict the 1-year and 2-year progression-free survival (PFS) of patients, and the C-index, AUC, and calibration curve were used to evaluate the performance of the model. Results:Logistic regression analysis results showed that differentiation, TNM staging, PG-SGA scores before and after radiotherapy (RT) and short diameter of residual lymph nodes were the independent predictors of clinical efficacy of ESCC patients treated with CRT. Cox regression analysis demonstrated that differentiation, TNM staging, PG-SGA scores before and after RT and short diameter of residual lymph nodes were the independent prognostic predictors of ESCC patients undergoing CRT. Conclusions:The short diameter of residual lymph nodes is significantly correlated with the efficacy and prognosis of ESCC patients undergoing CRT. The Nomogram prediction model established after comprehensive clinical baseline characteristics is a practical and reliable tool for predicting clinical prognosis of ESCC patients.

Predictive value of recurrence risk evaluation scale combined with inflammatory markers in the recurrence risk of cerebral infarction / 中华行为医学与脑科学杂志

Objective:To explore the predictive value of the recurrence risk estimator at 90-days(RRE-90) score combined with lipoprotein-associated phospholipase A2 (Lp-PLA2) and high sensitivity C-reactive protein(hs-CRP) in the recurrence risk of acute atherosclerotic cerebral infarction.Methods:Totally 400 patients with acute atherosclerotic cerebral infarction who were hospitalized for the first time in neurology department were followed up for 90 days.However, 8 cases were lost and 392 cases were included finally.According to recurrence or not, 64 cases were divided into recurrence group and 328 cases into non-recurrence group.The RRE-90 score was applied to all the participants and the levels of Lp-PLA2 was detected by enzyme-linked immunosorbent assay, the levels of hs-CRP was detected by immunoturbidimetry.The ROC curve was used to analyze the predictive value of RRE-90 score combined with Lp-PLA2 and hs-CRP for the recurrence risk of acute cerebral infarction.Results:Compared with the non-recurrence group(RRE-90: (3.07±1.01)score, Lp-PLA2: (103.53±8.11)μg/L, hs-CRP: (4.07±1.48)mg/L), the levels of (RRE-90 score: (4.11±0.78)score, Lp-PLA2: (121.52±13.95)μg/L, hs-CRP: (12.40±2.46) mg/L)in the recurrence group of cerebral infarction were significantly higher ( P<0.05, P<0.01). Compared with RRE-90 score (0.705), Lp-PLA2 (0.697), hs-CRP (0.622), RRE-90 score combined with Lp-PLA2 (0.752), RRE-90 score combined with hs-CRP (0.746), RRE-90 score combined with Lp-PLA2 and hs-CRP (0.782) had the largest area under the curve for predicting recurrence of cerebral infarction within 90 days, with statistical significance( P<0.05), sensitivity was 87.8%, specificity was 89.6%. Conclusion:RRE-90 score combined with Lp-PLA2 and hs-CRP detection can further improve the accuracy of predicting recurrence within 90 days in patients with cerebral atherosclerotic infarction, and the predictive value is high.

Clinical value of Cys C, Scr and Urea in the diagnosis of mycoplasma pneumoniae-associated nephritis / 中国基层医药

Objective:To discuss the clinical value of cystatin C (Cys C), serum creatinine (Scr) and serum urea nitrogen (Urea) in the diagnosis of mycoplasma pneumoniae-associated nephritis (MPAN), thus to provide reference basis for MPAN diagnosis.Methods:From June 2015 to June 2017, 50 patients with MPAN who were treated in Women and Children Hospital of Guangdong Province were selected as observation group, and 50 healthy children who underwent physical examination in the hospital during the same period were selected as control group.The observation group was divided into group A, group B and group C according to the level of endogenous creatinine clearance rate.The serum levels of Cys C, Scr and Urea were compared between the control group and the observation group.The levels of Cys C, Scr and Urea and the abnormal rate in group A, group B and group C were compared.Results:In the observation group, the Cys C levels of groups A, B and C were (1.25±0.13)mg/L, (1.74±0.34)mg/L, (3.72±1.33)mg/L, respectively, the Scr levels were (150.46±21.09)μmol/L, (268.57±108.68)μmol/L, (476.66±91.25)μmol/L, respectively, the Urea levels were (8.75±1.09)mmol/L, (11.49±1.50)mmol/L and (17.68±2.92)mmol/L, respectively.In the control group, the Cys C, Scr and Urea levels were (0.74±0.23)mg/L, (56.86±42.36)mol/L, (3.43±1.33)mmol/L, respectively.Compared with the control group, the Cys C level of the observation group was higher, the differences were statistically significant ( t=20.379, 22.991, 13.128, all P<0.05). The Scr level of each group in the observation group were higher than those of the control group, the differences were statistically significant ( t=21.768, 21.423, 43.640, all P<0.05). The Urea level of each group in the observation group was higher than that of the control group, the differences were statistically significant ( t=37.501, 33.404, 46.661, all P<0.05). The levels of Cys C, Scr and Urea in group C were higher than those in group B, the differences were statistically significant ( t=9.737, 9.333, 12.389, all P<0.05). The Cys C, Scr and Urea levels in group C were higher than those in group A, the differences were statistically significant ( t=19.880, 35.753, 27.127, all P<0.05). The Cys C, Scr and Urea levels in group B were higher than those in group A, the differences were statistically significant ( t=13.207, 11.163, 11.177, all P<0.05). In the early stage of renal function injury, namely renal insufficiency compensation stage, the abnormal rate of Cys C(62.07%) was significantly higher than that of Scr and Urea(10.34%, 24.13%). Conclusion:The serum Cys C, Scr and Urea levels of MPAN patients are all higher than healthy people.The more severe the renal function damage is, the higher the serum Cys C, Scr and Urea levels are, which can provide clinical reference for the diagnosis, disease prediction and auxiliary diagnostic criteria of MPAN.In particular, Cys C is more important for the early diagnosis of MPAN.

Social network characteristics of gay men college students in Tianjin seeking sex partners / 中国学校卫生

Objective@#Based on the MSM college students in Tianjin, this study aims to explore the demographic and behavioral characteristics of MSM with different sexual partners, and to provide evidence and information for intervention in combination with social networks.@*Methods@#According to the source and access of seeking sexual partners, 546 MSM of Tianjin college students aged 18-24 in 2018 Jan. and 2019 Dec. were divided into internet-based MSM (396) and traditional MSM (150). Chi-square test and rank-sum test were used to compare the demographic information, sexual behavior characteristics, HIV prevention and testing awareness, and psychoactive substance use of the two MSMs, and Logistic regression was used to explore factors affecting college students use of the Internet for sexual partners.@*Results@#Internet-based MSM has advantages in receiving HIV testing and safety consulting services, AIDS knowledge level, and peer education in the past year (P<0.05). The psychoactive substance use of the survey population reached more than 40%, and the awareness rates of pre-exposure prophylaxis and post-exposure prophylaxis were 32.98% and 55.32%, respectively. After multivariate Logistic regression analysis, MSM students who had received condom distribution, AIDS counseling and peer education (OR=2.16, 1.98, P<0.01) were more inclined to use the Internet for sexual partners.@*Conclusion@#Relevant departments can use the Internet to intervene in the prevention and control of MSM in colleges and universities in terms of AIDS-related knowledge, HIV testing, and mental substances.

Investigation on overlapping HIV/HBV infection in Yining City and its prevention and control / 公共卫生与预防医学

Objective To investigate the superinfection of human immunodeficiency virus (HIV) / hepatitis B virus (HBV) in Yining City, and to study on its prevention and control measures. Methods A total of 21 cases of HIV / HBV superinfection recorded by Yining CDC from January 2017 to October 2019 were investigated. Results In this group, the proportion of male (66.67%) was higher than that of female (33.33%), 36-60 years old and 17-35 years old (42.86% and 33.33%), junior high school and primary school and below (57.14% and 28.57%), sex workers and migrant workers (42.86% and 28.57%) were higher. The common clinical manifestations of this group were long-term fever, emaciation, general pain and so on. HIV was mainly sexually transmitted (61.90%). HBV was mainly transmitted by blood and sex (47.62% and 9.52%). The proportion of big three Yang was the highest (42.86%), followed by simple HBsAg (23.81%), small three yang (19.05%), HBsAg / anti HBC (14.29%). Conclusion In Yining City, 36-60 years old of male, junior high school and below, sex workers and migrant workers account for a relatively high proportion, and their clinical manifestations were complex, with clear features. Therefore, prevention and management should be strengthened.

Association between histone deacetylase 9 (HDAC9) level and poor prognosis of lung squamous cell cancer patients / 中国胸心血管外科临床杂志

@#Objective    To evaluate the expression level of histone deacetylase 9 (HDAC9) in lung squamous cell carcinoma (LUSC) tissues, to analyze its correlations with clinicopathological characteristics and prognosis of LUSC patients, and to explore the effect it exerts on the proliferation of LUSC cells. Methods    The expression level of HDAC9 was detected by immunohistochemistry staining (IHC), and its correlations with clinicopathological characteristics were analyzed by χ2 test. Survival analysis was performed using Kaplan-Meier method. Univariate and multivariate Cox proportional hazards model were employed to analyze independent predictors for overall survival (OS) of LUSC patients. CRISPR/dCas9 activation system was used to activate the transcription of HDAC9 gene in LUSC cell line EBC-1. CCK8 cell proliferation assay and colony formation test were performed to investigate the effect that transcriptional activation of HDAC9 exerts on the proliferation of LUSC cells. Results    Of the 129 LUSC patients, 39 (30.2%) were in the HDAC9 low expression group and 90 (69.8%) were in the HDAC9 high expression group. The OS of the patients with HDAC9 high expression was shorter than that of patients with HDAC9 low expression (P=0.032). The expression level of HDAC9 was associated with tumor grade (P=0.035), primary tumor size (P=0.041), and lymph node metastasis (P=0.013). The expression level of HDAC9 (P=0.023), tumor grade (P=0.003), primary tumor size (P=0.003), and lymph node metastasis (P=0.002) were independent predictors for OS of LUSC patients. Transcriptional activation of HDAC9 promoted colony formation of LUSC cells and cell proliferating curves showed that LUSC cells with HDAC9 transcriptional activation proliferated faster than non-targeting cells (F=52.7, P=0.002). Conclusion    LUSC patients with HDAC9 high expression have poorer prognosis than HDAC9 low expression ones. The expression level of HDAC9 is associated with tumor grade, primary tumor size, and lymph node metastasis, and is identified as an independent predictor for prognosis of LUSC. Transcriptional activation of HDAC9 promotes cell proliferation in LUSC. These results suggest that HDAC9 may serve as a promising biomarker for prognosis in LUSC.

Establishing the nursing bundle of preventing pressure injury related with operation: Based on evidence / 中国实用护理杂志

Objective@#To establish an evidence-based nursing bundle to prevent pressure injury related with operation and observe the clinical application of the bundle.@*Methods@#Clinical practice guidelines, systematic reviews/Meta-analysis, and randomized controlled trials (RCT) about prevention of pressure injuries related operation were acquired by searching databases, websites, manual retrieval and retrospective review. Two researchers independently screened and evaluated the literature, and experts′ advice were combined to form the prevention bundle of pressure injury related operation. A convenient sampling method was used to select 70 patients who underwent surgery in the Third Affiliated Hospital of Sun Yat-sen University. The pre-test for the clinical application of preventing the bundle was carried out to observe the incidence of pressure injury in patients and the implementation rate of each measure.@*Results@#This study included 22 RCTs, 6 systematic reviews/Meta analysis, and 6 clinical practice guidelines. The bundle for preventing pressure injury related operation included: preoperative pressure injury risk assessment, use of decompression flat car transporter, using a pressure reducing device to relieve local pressure, protection of dressing, placing the body position reasonably, adjusting intraoperative position, maintaining normal body temperature and skin cleansing. The frequency of implementation of the four measures of "use of decompression flat car transporter" , "protection of dressing" , "adjusting intraoperative position" , and "maintaining intraoperative skin cleansing" were 0, 17.1% (12/70) , 87.1% (61/70) , 5.7% (4/70) , respectively. The remaining measures were executed at a frequency of 100%. No pressure injury occurred from the beginning of operation to 6 days after operation among 70 patients.@*Conclusions@#The prevention bundle of pressure injury related operation can effectively prevent the occurrence of pressure injury related operation. Each of the measures included in the bundle is evidence-based and the interrelations of the various care measures are more focused, comprehensive, and systematic than the clinical practice guidelines.

Expression of MiR-148b-3p in Lung Adenocarcinoma and Its Correlation with Prognosis / 中国肺癌杂志

BACKGROUND@#MiR-148b-3p is an important microRNA that has been reported to be significantly related to various types of cancer, but its role in lung adenocarcinoma remains elusive. The purpose of this study is to detect the expression level of miR-148b-3p in lung adenocarcinoma specimens, and to analyze its correlation with the clinicopathological features as well as the prognosis of patients with lung adenocarcinoma.@*METHODS@#A total of 123 tumor specimens from lung adenocarcinoma patients who underwent surgical resection in our department from January 2011 to December 2012 were collected. The expression of miR-148b-3p was detected by quantitative real-time PCR (qRT-PCR), and its correlation with clinicopathological features of patients with lung adenocarcinoma was analyzed. Multivariate Cox proportional hazard models were used to analyze independent predictors of overall survival in patients with lung adenocarcinoma. The overall survival (OS) of patients in miR-148b-3p high expression group and miR-148b-3p low expression group were estimated by means of the Kaplan-Meier method and were compared using the Log-rank test method.@*RESULTS@#Of the 123 patients with lung adenocarcinoma, 71 were in miR-148b-3p high expression group and 52 in low expression group. MiR-148b-3p was significantly associated with tumor grade (P=0.001) and tumor size (P=0.007), but not with age, gender, smoking history, history of alcohol, tumor thrombus, pleural invasion, node status or metastasis status. Multivariate Cox proportional hazard model analysis showed that tumor size (P=0.032), node status (P=0.005) and miR-148b-3p expression level (P=0.047) were significant independent predictors of overall survival of patients with lung adenocarcinoma. Kaplan-Meier survival analysis showed that the overall survival of patients with high expression of miR-148b-3p was significantly better than that of patients with low expression (P=0.010).@*CONCLUSIONS@#MiR-148b-3p was significantly associated with tumor grade and tumor size in lung adenocarcinoma, and served as an independent predictor of overall survival of patients with lung adenocarcinoma. The overall survival of patients with high expression level of miR-148b-3p was significantly better than that of patients with low expression.

Evaluation of right ventricular systolic function and effects of maintenance hemodialysis on it in uremic patients by 4D RV Volume / 中华超声影像学杂志

To evaluate the right ventricular systolic function in uremia patients and the effects of maintenance hemodialysis on right ventricular systolic function by volume and strain parameters obtained by 4D RV Volume . Methods Seventy‐six patients with uremia and twenty‐two controls were selected . According to left ventricular ejection fraction ( LVEF) ,uremia patients were divided into normal LVEF uremia group and decreased LVEF uremia group . T hen normal LVEF uremia group was divided into maintenance hemodialysis group and non‐dialysis group . Conventional ultrasound parameters included :LVEF ,pulmonary artery systolic pressure ( PASP) and tricuspid annular plane systolic excursion ( T APSE‐2D) . 4D RV Volume parameters included : right ventricular end‐diastolic volume ( RVEDV ) , tricuspid annular plane systolic excursion ( T APSE‐4D ) ,right ventricular area change rate ( FAC ) ,right ventricular ejection fraction ( RVEF) and right ventricular free wall longitudinal systolic strain ( RV‐GLSfree ) . Results①Compared with the control group ,T APSE‐2D decreased significantly in the decreased LVEF uremia group ( P ＜0 .05) ,w hile there was no significant difference of T APSE‐2D in normal LVEF uremia group ( P ＞ 0 .05) . Compared with the control group and normal LVEF uremia group ,PASP increased significantly in the decreased LVEF uremia group ( P ＜ 0 .05 ) . Compared with the control group ,RVEDV increased significantly both in the normal LVEF and decreased LVEF uremia group ,w hich showed an increasing trend in these three groups ( P ＜0 .05) ,while T APSE‐4D ,FAC ,RVEF and RV‐GLSfree all decreased significantly and showed a decreasing trend in these three groups ( P ＜ 0 .05 ) . ② Compared with the control group , T APSE‐2D decreased significantly in non‐dialysis group ( P ＜0 .05) ,but there was no significant difference in uremia hemodialysis group ( P ＞0 .05) . Compared with the control group ,PASP and RVEDV increased and T APSE‐4D ,FAC ,RVEF and RV‐GLSfree decreased significantly in uremia hemodialysis group and non‐dialysis group ( P ＜ 0 .05 ) . Compared with non‐dialysis group , T APSE‐2D and T APSE‐4D increased significantly in hemodialysis group ( P ＜0 .05) ,while there was no significant difference in RVEDV ,FAC , RVEF and RV‐GLSfree in uremia hemodialysis group ( P ＞0 .05) . Conclusions 4D RV Volume could early and accurately evaluate the right ventricular systolic dysfunction in uremia patients . Furthermore ,w hen evaluating right ventricular systolic function in uremia patients treated with maintenance hemodialysis , indices such as right ventricular strain and volume parameters should be comprehensively considered .

Research progress of gingival aesthetics evaluation in aesthetic restoration of anterior area / 中华口腔医学杂志

Gingival aesthetics is one of the factors that affect the clinical effects of prosthesis, and is particularly important in the aesthetic restoration of anterior teeth. However, gingival aesthetics involves a number of parameters for which there is no standardized evaluating criteria available so far. In addition to implant, other methods of restoration still lack recognized aesthetic evaluation systems for clinical use. At present, there are lots of solutions to improve anterior gingival esthetics, and most of the solutions can effectively improve the aesthetic effect in clinical treatment. This article reviews the aesthetics criteria of the anterior gingival area and the aesthetics restoration methods.

Evaluating the changes of intra-and interatrial synchronization with age in normal adults by dual gate Doppler / 中华超声影像学杂志

Objective To evaluate the changes of intra-and interatrial synchronization with age in normal adults by dual gate Doppler and discuss the feasibility of dual gate Doppler in assessing atrial synchronization.Methods Fifty-seven healthy volunteers were divided into three groups according to age:group A (20-39 years old,n =20),groupB(40-59 years old,n =21),groupC (60-79 years old,n =16).The time interval of the onset of a'wave between mitral annular septal and lateral site was T1 by dual gate Doppler,which was used to evaluate left atrial synchronization.The time intervals from the onset of a'wave at tricuspid annular right ventricular free wall site to a'wave at tricuspid annular septal site and mitral annular lateral site were T2 and T3,which were respectively used to evaluate right atrial and interatrial synchronization.With traditional Doppler technique,the time intervals from the onset of P wave to the onset of a'wave at the mitral annular lateral site (P-L),the mitral annular septal site (P-S),and the tricuspid annular right ventricular free wall site (P-RVFW) were measured.The time differences between P-L and P-S,between P-S and P-RVFW,and between P-L and P-RVFW were t1 (left atrial synchronization),t2 (right atrial synchronization),t3 (interatrial synchronization).The greater time interval predicted the worse synchronization.Results ① Systolic and diastolic blood pressure elevated with age among three groups (P＜0.05).Compared with group A,the ratio (E/e') of early diastolic transmitral flow velocity (E) and mitral annular velocity of septal site (e'),and late diastolic transmitral flow velocity increased in group B and C.In contrast with group A and B,left atrial volume (LAV) increased,and E decreased in group C (all P ＜0.05).②Compared with group A,T1,T2,T3 and t1,t2,t3 increased in group B and C (all P ＜0.05).③T1,T2 and T3 were positively correlated with age,body mass index,systolic blood pressure,left atrial systolic antero-posterior diameter and E/e'(all P ＜0.05).Besides,T1 was positively correlated with LAV (P ＜0.05).T3 was positively correlated with LAV and right atrial upper-inferior diameter.④ The parameters of atrial synchronization in dual gate Doppler were concordant with that in traditional Doppler technique.And the measurements of two methods were correlated (r =0.78,P ＜0.01).For inter-and intraobservers,the interclass correlation coefficient with dual gate Doppler was higher and 95 ％ confidence interval range was smaller.Conclusions The intra-and interatrial synchronization reduces with age in normal adults.Dual gate Doppler is feasible in evaluating atrial synchronization,which can provide more repeatable measurements and can be a new prospective method to assess atrial synchronization.

Research progress of animal models of renal fibrosis and their characteristics / 中国实验动物学报

Renal fibrosis is a common pathological pathway of chronic kidney diseases that leads to end-stage renal failure. The pathological changes include glomerulosclerosis and renal interstitial fibrosis. Ideal animal models for the study of pathologic mechanisms and drug development of chronic kidney disease are of great significance. At present, the method of establishment of animal models include drug or toxin induction, surgical models and gene knockout, etc. Different animal models have various characteristics of renal function and pathology, but can not completely simulate human chronic kidney disease, suggesting the complexity of chronic kidney diseases. So the preparation and research of the animal models is important for understanding the pathological mechanisms, prevention and treatment of renal fibrosis.

Systematic evaluation of pulmonary inflammation induced by fine particulate matter in a mouse model / 中国实验动物学报

Objective The aim of this study was to establish a PM2.5air pollution-induced mouse model of pulmo-nary inflammation and investigate its pathogenetic mechanism. Methods 150 specific pathogen-free BALB/c mice were subjected to intratracheal instillation of 2.5,5,or 10 mg/kg PM2.5suspension to construct airborne inflammation models. The blank group and saline group were taken as a control group. Mice were euthanized after 3rd,7th,21st,35th and 49th days to assess the pathological changes in lung tissues using HE staining and ELISA. Results The success rate of tracheal instillation was 96%. With the time prolongation and increasing doses of intratracheal PM2.5instillation,the histopathologi-cal scores of lung tissue increased gradually,showing alveolar macrophages with engulfed particles and lymphocyte accumu-lation in bronchiole and widened inter-alveolar space. The levels of BALF IL-6 and TNF-α of lung tissue homogenate were significantly increased in the high dose PM2.5(10 mg/kg)group, compared with the control groups. Conclusions A mouse model of PM2.5air pollution-induced lung inflammation is successfully established by intratracheal instillation of PM2.5suspension.This method is proved to be simple,safe and reliable,and is useful for further study of air pollution-in-duced and other inflammatory mechanisms.

Logistic regression analysis on influencing factors of the collateral circulation formation in patients with acute cerebral infarction / 中国综合临床

Objective To explore the influencing factors of the collateral circulation formation in patients with acute cerebral infarction.Methods Three hundred and fifty-two patients with acute cerebral infarction were included in this study,the clinical date of their head and neck 256 slice spiral CT angiography (CTA)examination was analyzed.According to the formation of collateral circulation in the head and neck CTA imaging results,it is divided into the collateral circulation group and the non-collateral circulation group.The clinical data of the two groups were compared.The influencing factors of the formation of collateral circulation in patients with acute cerebral infarction were analyzed by single factor analysis and multivariate logistic regression analysis.Results (1)In 352 cases of acute cerebral infarction,197 cases(56.0%)had collaterals,155 cases (44.0%)had none collateral.(2)Single factor analysis showed that age(t=-2.860,P=0.004),hypertension combined with diabetes(χ2 = 10.709,P= 0.001),history of TIA(χ2 = 4.626,P= 0.034),low density lipoprotein(t=-2.176,P=0.030),high homocysteine(t=2.885,P=0.004),cerebral vascular stenosis(Z=-5.936,P=0.000),posterior circular lesions(χ2=8.548,P=0.004)were the influencing factors in the formation of collateral circulation.(3)Multivariate Logistic regression analysis showed that old age(OR=1.031;95%CI=1.008-1.054;P=0.007),hypertension combined with diabetes(OR= 2.009;95%CI=1.159-3.482;P=0.013),high homocysteine(OR=1.023;95%CI,1.005-1.041;P=0.014),circular lesions(OR=1.727;95%CI=1.063-2.804;P=0.027)were relatively independent risk factors in acute cerebral infarction patients with none circulation,the degree of cerebral vascular stenosis(OR=0.507;95%CI=0.389-0.661;P=0.000),low density lipoprotein(OR=0.723;95%CI=0.532-0.982;P=0.038)served as protective factor.Conclusion Old age,hypertension combined with diabetes,high homocysteine and posterior circulation lesions are risk factors for the formation of collateral circulation in patients with acute cerebral infarction,cerebral vascular stenosis degree and low density lipoprotein can promote the formation of collateral circulation.

Effect of Longzhu Ointment on Allergic Contact Dermatitis / 中国药师

Objective: To explore the effect and mechanism of Longzhu ointment in the treatment of allergic contact dermatitis.Methods: Allergic contact dermatitis mouse model was induced by dinitrobenzene (DNFB) and the mice were randomly divided into the model group, matrix group, Longzhu ointment group and hydrocortisone butyrate group.0.5% DNFB was used for sensitization on abdomen of mice one and two days before the administration, and 0.2% DNFB was used on the right ears of mice after 6-day administration to establish mouse ACD model.A day after the excitation of dermatitis, the ear swelling degree was determined, the changes of histopathology was observed, and the immunohistochemical methods were performed to quantify the expression of TNF-γ and macrophage surface markers CD68 in the tissue samples.Results: The ear swelling degree in the group treated with Longzhu ointment was significantly reduced (P <0.01).Compared with the postive control group,the difference was not statistically significant(P＞0.05).HE staining showed that tissue edema decreased obviously.The immunohistochemistry analysis revealed that the expression of INF-γ in Longzhu ointment group was obviously reduced.Under the microscope with magnification of 200 times, CD68 positive cells in Longzhu ointment group was significantly reduced than those in the model group(P＜0.01).The expression of CD68 positive cells in butyric acid hydrocortisone group was not significantly different from that in Longzhu Ointment group.Conclusion: Longzhu ointment can inhibit allergic contact dermatitis obviously, and the mechanism may be related to the inhibition of lymphocyte secretion INF-γ and the reduction of macrophage infiltration.

Relationship between anesthesia factor and myocardial injury in patients undergoing cardiac surgery with cardiopulmonary bypass: dexmedetomidine combined with sevoflurane anesthesia / 中华麻醉学杂志

Objective To evaluate the relationship between the anesthesia factor and myocardial injury in the patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).Methods Eightyeight patients of both sexes,aged 42-71 yr,weighing 59-83 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),scheduled for elective coronary artery bypass grafting with CPB,were divided into 4 groups (n =22 each) using a random number table:routine anesthesia control group (group C),dexmedetomidine-based anesthesia group (group D),sevofluranebased anesthesia group (group S) and dexmedetomidine combined with sevoflurane anesthesia group (group DS).After tracheal intubation,0.2％-2.1％ sevoflurane was inhaled until the beginning of CPB in S and DS groups.In D and DS groups,dexmedetomidine was intravenously infused as a loading dose of 1 μg/kg over 10 min before induction of anesthesia,followed by an infusion of 0.4 μg · kg-1 · h-1 until the end of surgery.Before induction of anesthesia,before CPB,after the end of CPB,immediately after the end of surgery and at 24 h after surgery,venous blood samples were collected for determination of plasma creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) concentrations by immunofluorescence.The restoration of spontaneous heart beat and adverse events such as hypotension,malignant arrhythmia,cardiac arrest and respiratory depression during surgery and within 24 h after surgery were recorded.Results Compared with group C,the plasma concentrations of CK-MB and cTnI were significantly decreased in the other three groups (P＜0.05).The plasma eoncentrations of CK-MB and eTnl were significantly lower in group DS than in S and D groups (P＜0.05).There were no significant differences in the rate of restoration of spontaneous heart beat among the four groups (P＞ 0.05).No adverse events were found during surgery and within 24 h after surgery in the four groups.Conclusion Dexmedetomidine combined with sevoflurane anesthesia is helpful in reducing myocardial injury and provides better efficacy than either alone in the patients undergoing cardiac surgery with CPB and is more suitable for cardiac surgery with CPB.

Assessment of left ventricular diastolic function in patients with uremia by diastolic strain rate parameters / 中华超声影像学杂志

Objective To evaluate the left ventricular diastolic function in patients with uremia by two-dimensional speckle tracking technology ( 2D-STI ) . Methods Ninety-three patients with uremia ( serum creatinine value≥ 700 μmol/l) and 29 controls were included . Uremia patients were divided into group with decreased LVEF ( LVEF < 50％ ,group C ,19 cases) and group with normal LVEF ( LVEF≥50％ ) . The latter were divided into group with normal diastolic function ( group A ,31 cases) and group with diastolic dysfunction ( group B ,23 cases) according to the diastolic function;pulsed wave tissue Dopper imaging datas included:diastolic velocity e1′,a1′ and e2′,a2′ at septal or lateral sites of mitral annulus , average E/e′and e′/a′. 2D-STI strain and strain rate parameters included:the longitudinal peak systolic strain ( GLS) ,the longitudinal peak systolic strain rate ( LSRs) ,longitudinal peak strain rate in early diastole (LSRe)andE/LSRe.Results ①Systolicfunctionparameters:comparedwithcontrolgroup,LVEF decreased significantly only in group C( P <0 .05) ,while there was no significant difference among group A ,B and control group ( P> 0 .05 ) ;GLS in group A ,B and C decreased significantly and showed a decreasing trend among these three groups( P <0 .05) ;LSRs in group B and C decreased significantly ,while there was no significant difference between group A and control group( P > 0 .05) . ② Diastolic function parameters:compared with control group ,the average E/e′decreased significantly in group B and C( P <0 .05) ,while group A showed no significant difference( P > 0 .05) . Compared with group A ,the average E/e′increased significantly in group B and C ( P < 0 .05) . Compared with control group ,LSRe in three uremia groups decreased significantly ,which showed a decreasing trend among these three groups ( P <0 .05) ;however ,E/LSRe in three uremia groups increased significantly and showed an increasing trend among these three groups ( P < 0 .05 ) . ③ The correlation analysis showed that there were positive correlations between average e′ and LSRe and between average E/e′ and E/LSRe in uremic patients . Conclusions In patients with uremia ,left ventricular systolic and diastolic function impaired in the early phase . Strain rate parameters in diastole especially E/LSRe obtained by 2D-STI can be used as sensitive , early parameter for evaluation of left ventricular diastolic dysfunction .