Search

This study aims to develop an independent control system for radiofrequency electrode arrays, intended for the conformal ablation of unwanted tissues. Unlike traditional single radiofrequency voltage applications, this study employs high-frequency transformer isolation and radiofrequency load matching technologies to divide the radiofrequency signal source into eight independent groups. Each group operates at the same phase and frequency but with different voltage values. Experimental results indicate that the designed system can independently output various combinations of radiofrequency signals. The actual output voltage has a relative error controlled within 6%, the frequency error is less than 0.5%, and the phase difference among the groups is less than 1°. In the biomimetic tissue heating experiments, it is found that by controlling the voltage of each electrode within the electrode array, ablation of different shapes can be achieved, and the ablation depth is positively correlated with the applied radiofrequency voltage.

Objective: To observe the effects of electroacupuncture (EA) at "Jiaji" (EX-B 2) on extracellular matrix (ECM) of chondrocytes and inflammatory reaction in rabbits with Modic changes (MC) of cartilage endplate, and to explore the mechanism of EA in treating MC of endplate cartilage., Methods: Eighteen male New Zealand white rabbits were randomly divided into a sham operation group, a model group and an EA group, 6 rabbits in each group. Based on the autoimmune theory, MC model was established by embedding autogenous nucleus pulposus in the rabbits of the model group and the EA group, based on autoimmunity. After successful modeling, EA was applied at bilateral "Jiaji" (EX-B 2) of L 5 and L 6 in the EA group, with disperse-dense wave, 2 Hz/15 Hz in frequency and 1 mA in current intensity, 20 min a time, once a day, 1-day interval was taken after continuous 6-day intervention, for 4 weeks totally. Before and after modeling, as well as before and after intervention, the comprehensive response score was observed. After modeling and intervention, magnetic resonance imaging (MRI) was used to observe the signal intensity of intervertebral disc and cartilage endplate. After intervention, the morphology of chondrocytes of cartilage endplate was observed by HE staining; the positive expression of a disintegrin and metalloproteinase with thrombospondin motif-5 (ADAMTS5) and Aggrecan in the cartilage endplate was detected by immunohistochemistry; the levels of inflammatory factors i.e. interleukin-1β (1L-1β) and tumor necrosis factor-α (TNF-α) in the cartilage endplate were detected by ELISA; the protein expression of ADAMTS5, Aggrecan, matrix metalloproteinase-13 (MMP-13), IL-1β and TNF-α in the cartilage endplate was detected by Western blot., Results: Compared with the sham operation group, in the model group, the comprehensive response score was decreased ( P <0.01); L 5 /L 6 intervertebral disc and the cancellous bones of endplate vertebral body showed low signal and unclear boundary; the chondrocytes of the cartilage endplate increased significantly, the cells were enlarged and hypertrophic, and the nuclei were wrinkled and clustered; the positive expression of ADAMTS5 as well as the levels of IL-1β and TNF-α were increased ( P <0.01), while the positive expression of Aggrecan was decreased ( P <0.01) in the cartilage endplate; the protein expression of ADAMTS5, MMP-13, IL-1β and TNF-α was increased ( P <0.01), while that of Aggrecan was decreased ( P <0.01) in the cartilage endplate. Compared with the model group, in the EA group, the comprehensive response score was increased ( P <0.01); the signal of L 5 /L 6 intervertebral disc and the cancellous bones of endplate vertebral body was enhanced; the chondrocytes of the cartilage endplate were reduced, the nuclei were slightly crumpled and scattered; the positive expression of ADAMTS5 as well as the levels of IL-1β and TNF-α were decreased ( P <0.05, P <0.01), while the positive expression of Aggrecan was increased ( P <0.01) in the cartilage endplate; the protein expression of ADAMTS5, MMP-13, IL-1β and TNF-α was decreased ( P <0.05, P <0.01), while that of Aggrecan was increased ( P <0.05) in the cartilage endplate., Conclusion: EA at "Jiaji" (EX-B 2) can delay the MC of cartilage endplate. The mechanism may be related to inhibiting the degradation of ECM of chondrocytes and the secretion of inflammatory factors, and repairing the degeneration of endplate cartilage.

Recently, with the rapid growth of the global population and the exhaustion of resources, exploration activities in extreme environments such as the polar regions, the outer space, the deep sea, the deep underground and highlands are becoming increasingly more frequent. This in-depth exploration of the external environment and the consequent dramatic changes in lifestyles impact on sleep, a basic life activity of humans, in ways that cannot be overlooked. the basic life activity of human beings. Sleep, a basic life activity and the result of the evolution of organisms to adapt to their environment, is closely associated with sleep homeostasis and endogenous rhythms. However, external environmental changes and lifestyle shifts in extreme environments have had a significant impact on the patterns and the quality of sleep in humans. Furthermore, this impact can lead to many physiological and psychological problems, posing a great threat to human health. In this review, we delved into the specific effects of different extreme natural environments and enclosed environments on sleep, elaborating on how these environments alter the patterns and the quality of sleep in humans. In addition, we summarized the changes in human sleep under extreme environments to help gain a better understanding of the mechanisms by which these specific environments impact human sleep. It is expected that this review will provide a solid theoretical foundation for optimizing long-term survival strategies in extreme environments and help humans adapt to and overcome the challenges posed by extreme environments more effectively., Competing Interests: 利益冲突　所有作者均声明不存在利益冲突, (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Office of Journal of Sichuan University (Medical Sciences).)

Brominated flame retardants (BFRs) are a kind of brominated compounds widely used in electronic and electrical appliances, textiles, construction materials and other industrial products to improve the flame retardant property. Because of its strong chemical stability, environmental persistence, long-distance transmission, biological accumulation, the exposure of humans and organisms in the ecosystem is increasing, and its potential biological effects are of great concern. Now BFRs can be detected in breast milk, serum, placenta and cord blood. Studies have shown that exposure to BFRs during pregnancy can lead to adverse birth outcomes such as low birth weight, malformation, gestational age changes and impairment of neurobehavioral development. This article summarizes the pollution and population exposure of three traditional BFRs, polybrominated diphenyl ethers (PBDEs), hexabromocyclododecane (HBCD), and tetrabromobisphenol A (TBBPA), as well as the impact and mechanism of prenatal exposure on offspring birth outcomes and growth and development. It explores the harm of prenatal exposure to BFRs to offspring and proposes preventive measures for occupational populations for reference.

Objective: To compare the efficacy of conventional open ankle fusion and three dimensional(3D) printed guide plate assisted arthroscopic ankle fusion. Methods: A retrospective cohort study was performed on 256 patients with advanced traumatic ankle arthritis, who were admitted to the Department of Orthopaedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from May 2018 to February 2023 and underwent ankle fusion procedures. The study cohort comprised 119 males and 137 females, with an age of (59.6±9.5) years (range: 37 to 83 years). Among them, 175 cases underwent internal fixation with plates and screws (58 cases through the combined medial and lateral approach, and 117 cases through the simple lateral approach), 48 cases underwent internal fixation with screws through the anterior approach (conventional open group), and 33 cases underwent minimally invasive arthroscopic ankle fusion assisted by 3D printed guide plate (3D printed guide plate arthroscopy group). Propensity score matching was employed to achieve a 1∶1 match(caliper value=0.02) between the baseline characteristics of patients in the 3D printed guide plate arthroscopy group and the conventional open group. Perioperative and follow-up data between the two groups were compared using the t -test, Mann-Whitney U test, Wilcoxon signed rank test, χ ² test or corrected χ ² test as appropriate. Results: Matching was successfully achieved with 20 cases in both the 3D printed guide plate arthroscopy group and the conventional open group, and there were no statistically significant differences in baseline characteristics between the two groups (all P >0.05). The operation time in the 3D printed guide plate arthroscopy group was significantly longer than that in the conventional open group ((88.9±5.6) minutes vs. (77.9±11.7) minutes; t =-2.392, P =0.022), while the frequency of intraoperative fluoroscopies ((1.7±0.8) times vs. (5.2±1.2) times; t =10.604, P< 0.01) and length of hospitalization ((5.5±0.9) days vs. (6.4±1.5) days; t =2.480, P =0.018) were significantly lower in the 3D printed guide plate arthroscopy group compared to the conventional open group. The fusion rate was 95.0% (19/20) in the 3D printed guide plate arthroscopy group and 85.0% (17/20) in the conventional open group, with no statistically significant difference between the two groups ( χ ²=0.278, P =0.598). The fusion time was (12.1±2.0) weeks in the conventional open group and (11.1±1.7) weeks in the 3D printed guide plate arthroscopy group, with no statistically significant difference between the two groups ( t =1.607, P =0.116). At the final follow-up, the American Orthopedic Foot and Ankle Society ankle hindfoot scale was (72.6±5.5)points in the 3D printed guide plate arthroscopy group and (70.5±5.8)points in the conventional open group, with no statistically significant difference between the two groups ( t =-1.003, P =0.322). The pain visual analogue score of the 3D printed guide plate arthroscopy group was ( M (IQR)) 1.50 (1.00) points, lower than that of the conventional open group by 3.00 (1.00) points, with statistically significant differences ( Z =-3.937, P< 0.01). There was no significant difference in complication rate between the conventional open group and the 3D printed guide plate arthroscopy group (25.0%(5/20) vs. 5.0%(1/20), χ ²=1.765， P =0.184). Conclusion: 3D printed guide plate assisted arthroscopic ankle fusion exhibited several advantages, including reduced frequency of fluoroscopies, alleviation of postoperative pain, and decreased complications and length of hospitalization.

Objective: To explore the genetic etiology of a child with Cowden syndrome 1 (CS1)., Methods: A child who had visited the Ningbo Women and Children's Hospital on August 26, 2022 was selected as the study subject. Clinical information of the child was collected. Genomic DNA was extracted from peripheral blood samples of the child and his family members and subjected to whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing., Results: The child, a 13-year-old boy, had manifested with severe mental retardation, hyperactivity, autistic behavior, sparse and prominent teeth, macrocephaly, and skin freckles on the penis. His mother had presented with multiple papules, hamartomatous polyps, thyroid adenoma and macrocephaly. WES results revealed that the child has harbored a nonsense c.781C>T (p.Q261*) variant of the PTEN gene, which was inherited from his mother. Based on the guidelines from the American College of Medical Genetics and Genomics, the c.781C>T variant was classified as likely pathogenic (PVS1+PM2&#95;Supporting)., Conclusion: The c.781C>T variant of the PTEN gene probably underlay the pathogenesis in the child and his mother. Above finding has facilitated genetic counseling for this family.

Purpose: To study the structural characteristics of oral microorganisms in children with caries by 16S rRNA high-throughput sequencing technology., Methods: Thirty healthy children aged 3-5 years were enrolled as subjects. According to the index of dmfs, they were divided into caries-free (CF) group (15) and early childhood caries (ECC) group(15). To compare the differences in bacterial community structure, samples of saliva and dental plaque were collected, and high-throughput sequencing was conducted using the Illumina Miseq sequencing platform. Bioinformatics analysis was used to analyze the difference of microbial community structure and diversity with SPSS 23.0 software package., Results: Microbial diversity in ECC group was significantly lower than CF group. At phylum level, Actinobateria was more abundant in saliva samples of ECC group, while Firmicutes was more abundant in plaque samples of CF group. At genus level, the abundance of Lautropia of CF group was higher in saliva samples while Cardiobacterium, Gemella and Granulicatella were abundant in plaque samples. The abundance of Rothia of ECC group was higher in saliva samples and Corynebacterium was abundant of ECC group in plaque samples., Conclusions: There are significant differences in the species and composition of microbial community in saliva and plaque of children with or without caries. Specific microorganisms are related to the occurrence of ECC, and screening specific microorganisms is helpful for early prediction and prevention of ECC.

Objective: To explore the correlation between 5 dimensions of personality, physical activity (PA), and bone mineral density (BMD) among college students., Methods: A total of 705 undergraduates (329 males and 376 females) from a sports university were recruited. Based on their sports training experience, the participants were divided into 6 major sports groups, including ball sports, skilled sports, competitive sports, track and field, leisure sports, and no sports. Students with professional sports training (ie, athletes) were categorized into ballgame, skilled, competitive, and track and field groups, while the rest (non-athletes) were placed in leisure and no sports groups. Ten-Item Personality Inventory in China (TIPI-C), or the 5-factor model of personality, was used to measure the 5 personality dimensions of openness, conscientiousness, extraversion, agreeableness, and neuroticism of the participants. Their daily level was measured with GT3X+ triaxial accelerometers over 7 continuous days. Then, parameter thresholds were established and the participants' PA was categorized as light (LPA), moderate (MPA), and vigorous (VPA). The bone mineral density (BMD) of arms, legs, and the total body was measured using dual-energy X-ray absorptiometry. The mediation effect of PA and that of the 5-factor model of personality were tested using PROCESS and Sobel tests. The correlation between the 5 personality dimensions, PA, and BMD was explored, with PA and the 5 personality dimensions as mediator variables. A comparison of PA and BMD was conducted across the 6 major sports groups. The correlation between PA of different intensities and BMD was also analyzed using Spearman's correlation., Results: Although there were 90 potential relationships between PA, the 5 personality dimensions, and BMD, only 3 were significant. When conscientiousness was used as an independent variable and MPA, as a mediating variable, statistically significant differences in PROCESS results were reported ( P <0.01), with MPA mediating 17.3% of arm BMD, 19.4% of leg BMD, and 19.1% of total body BMD. Among male students, there was no significant difference in LPA among the 6 groups, but significant differences in MPA and VPA ( P <0.05). Among female students, significant differences in LPA, MPA, and VPA were observed in all 6 groups and the differences between MPA and VPA were especially prominent ( P <0.05). For both males and females, the differences in arm, leg, and total body BMD across the 6 groups were statistically significant ( P <0.05), with these differences being more pronounced in females. There was no correlation between LPA and BMD in either sex. MPA and VPA were positively correlated with BMD, with MPA correlating with arm, leg, and total body BMD (males, Spearman's correlation [ r s ]: 0.11-0.14, P <0.05; females, r s : 0.20-0.23, P <0.01). VPA correlated with arm, leg, and total body BMD (males, r s : 0.11-0.23, P <0.05; females, r s : 0.26-0.30, P <0.01)., Conclusion: MPA is associated with BMD in college students scoring high in the conscientiousness dimension of personality. In addition, there is a weak positive correlation between both MPA and VPA and BMD levels, with these associations being more pronounced in females., Competing Interests: 利益冲突　所有作者均声明不存在利益冲突, (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Board of Journal of Sichuan University (Medical Sciences).)

Anti-caries strategies that based on the regulation of oral micro-ecology have recently drawn broad attention. Intelligent antibacterial materials have shown great potential for ecological anti-caries strategies, which can response to microenvironment of dental caries or external stimuli and inhibit cariogenic biofilms precisely. This technology could improve local anti-caries effect and help maintain oral micro-eubiosis. Here, we reviewed recent progress in intelligent anti-bacterial materials for dental caries. The future research direction was also prospected. We hope that by discussing about this new technology of prevention and treatment for dental caries, this review could provide ideas for the research on novel anti-caries materials.

Objectives: To observe the effect of electroacupuncture (EA) at "Jiaji"(EX-B2) on body mass, motor function, expression of caveolin-1 (Cav-1) in nucleus pulposus cells and annulus fibrosus tissue, telomerase activi-ty, relative telomere length and different cell cycle ratio of nucleus pulposus cells in rabbits with intervertebral disc degeneration(IVDD), so as to investigate its mechanism underlying delaying senescence of the degenerated lumbar intervertebral disc nucleus pulposus cells., Methods: Twenty-five male New Zealand rabbits with mature bones were divided into control, sham operation, model, EA, and acupuncture groups, with 5 rabbits in each group. The IVDD model was established by inserting kirschner wires to the vertebral bone surface between the lumbar (L)4 and L5 vertebrae, followed by applying continuous axial pressure for 28 d. EA (2 Hz/15 Hz, 1-2 mA) or acupuncture (only insertion of acupuncture needles into bilateral EX-B2, but without electrical stimulation) was applied to bilateral EX-B2 for 20 min, once daily, 6 times a week for 4 weeks. The hindlimb locomotor function (locomotor score) was assessed by using Faden's and colleagues' methods. The general conditions of rabbits in each group were observed, and their body weight changes were measured every week. Nucleus pulposus cells were isolated using enzyme digestion method. After the treatment, the Cav-1 positive cell counts in nucleus pulposus cells and annulus fibrosus tissues were detected by immunohistochemistry, and the telomerase activity of nucleus pulposus cells was detected by PCR-ELISA. The relative telomere length of nucleus pulposus cells was measured by real-time quantitative polymerase chain reaction (real-time qPCR), and the cell cycle of nucleus pulposus was detected by flow cytometry., Results: Compared with the sham operation group, the body mass from 4 to 11 week, locomotor score at 4, 7 and 11 week, telomerase activity, relative telomere length and the proportion of cells in G2/M phase of nucleus pulposus cells were significantly decreased ( P <0.01), while Cav-1 positive cell counts of nucleus pulposus and annulus fibrosus tissue, and the proportion of nucleus pulposus cells in the G0/G1 phase considerably increased ( P <0.01) in the model group. Relevant to the model group, the EA group rather than the acupuncture group had an increase in the body mass from 8 to 11 week, locomotor score at 11 week, telomerase activity, relative telomere length of nucleus pulposus cells, and the proportion of nucleus pulposus cells in G2/M phase ( P <0.01), and a decrease in the Cav-1 positive cell counts of nucleus pulposus and annulus fibrosus tissue and the proportion of cells in G0/G1 phase ( P <0.01). No significant differences were found between the model and acupuncture groups in all the indexes mentioned above., Conclusions: EA at EX-B2 has a bene-ficial effect in improving motor function in rabbits with IVDD, which may be related to its functions in reducing the expression of Cav-1 in nucleus pulposus cells and annulus fibrosus, improving cycle arrest, enhancing the telomerase activity and the relative telomere length of nucleus pulposus cells, delaying the senescence of nucleus pulposus cells of the degenerated lumbar intervertebral discs.

Objectives: The interaction between elderly people with disabilities and their caregivers and the improvement of caregiver burden is important for elderly people with disabilities and their caregivers. This study aims to explore the multiple mediating roles of caregiver's caring ability and resilience in depression in the elderly people with disabilities on caregiver burden., Methods: A total of 246 elderly people with disabilities at home and their family caregivers from 5 regions were investigated by questionnaires, including the General Information Questionnaire, the Patient Health Questionnaire, the Family Caregiver Task Inventory, the Resilience Scale, and the Caregiver Burden Interview. A multiple mediation model was constructed and tested., Results: Univariate analysis showed that the caregiver burden of disabled elderly men is higher than that of women; the lower the level of self-care of disabled elderly individuals, the greater the burden on their caregivers (both P <0.05). Correlation analysis showed that depression of the disabled elderly people was positively correlated with the caregiver burden ( P <0.01). Caregiver's caring ability was positively correlated with caregiver's resilience ( P <0.01), and both were negatively correlated with caregiver burden (both P <0.01). The multiple mediating effects of caregiver caring capacity and resilience between depression of the disabled elderly people and caregiver burden were significant, with the mediating effects of caregiver caring capacity and resilience accounting for 68.9% and 26.2% of the total effect, respectively., Conclusions: Depression in the elderly people with disabilities can indirectly affect caregiver burden through the caregiver's caring ability and resilience. Families of older people with disabilities need to focus on both the elderly and their caregivers. It is possible to reduce the caregiver burden and improve the physical and mental health of the dyads by empowering the caregiver's caring ability and resilience.

It has been well documented that exercise can improve bone metabolism, promote bone growth and development, and alleviate bone loss. MicroRNAs (miRNAs) are widely involved in the proliferation and differentiation of bone marrow mesenchymal stem cells, osteoblasts, osteoclasts and other bone tissue cells, and regulation of balance between bone formation and bone resorption by targeting osteogenic factors or bone resorption factors. Thus miRNAs play an important role in the regulation of bone metabolism. Recently, regulation of miRNAs are shown to be one of the ways by which exercise or mechanical stress promotes the positive balance of bone metabolism. Exercise induces changes of miRNAs expression in bone tissue and regulates the expression of related osteogenic factors or bone resorption factors, to further strengthen the osteogenic effect of exercise. This review summarizes relevant studies on the mechanism whereby exercise regulates bone metabolism via miRNAs, providing a theoretical basis for osteoporosis prevention and treatment with exercise.

Objective: To explore the clinical and genetic characteristics of a fetus with Melnick-Needles syndrome (MNS)., Methods: A fetus with MNS diagnosed at Ningbo Women and Children's Hospital in November 2020 was selected as the study subject. Clinical data was collected. Pathogenic variant was screened by using trio-whole exome sequencing (trio-WES). Candidate variant was verified by Sanger sequencing., Results: Prenatal ultrasonography of the fetus had shown multiple anomalies including intrauterine growth retardation, bilateral femur curvature, omphalocele, single umbilical artery, and oligohydramnios. Trio-WES revealed that the fetus has harbored hemizygous c.3562G>A (p.A1188T) missense variant of the FLNA gene. Sanger sequencing confirmed that the variant was maternally derived, whilst its father was of a wild type. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was predicted to be likely pathogenic (PS4+PM2&#95;Supporting+PP3+PP4)., Conclusion: The hemizygous c.3562G>A (p.A1188T) variant of the FLNA gene probably underlay the structural abnormalities in this fetus. Genetic testing can facilitate accurate diagnosis of MNS and provide a basis for genetic counseling for this family.

Objective: In this study, the results of forward and reverse blood typing of a male patient diagnosed as bronchiectasis were inconsistent, which were type O and type A respectively. Multiple experiments including genotyping and sequencing and family investigation were carried out to determine the subtype of ABO blood group and explore the serological characteristics of this subtype., Methods: Standard serological techniques were used to conduct forward and reverse typing, reverse blood typing enhancement test, H antigen identification, absorption-elution test, salivary blood group substances test, and PCR-SSP method for ABO genotyping and exon 6 and 7 sequencing., Results: The proband's blood group was type O by forward typing, but antigen A could be detected by absorption-elution test, anti-A1 could be detected by reverse blood typing enhancement test, it was found that there was substance H but no substance A in saliva, and the serological characteristics were consistent with Ael subtype. Gene sequencing analysis showed that there was a c.625T>G base substitution on the basis of A102 , which had never been reported before. Family survey showed that c.625T>G base substitution appeared in three generations of the family., Conclusion: In this study, a new subtype A with Ael serological characteristics caused by c.625T>G mutation was identified. c.625T>G base substitution results in the weakening of A antigen, and this mutation can be stably passed down to future generations.

Pulpitis, periodontitis, jaw bone defect, and temporomandibular joint damage are common oral and maxillofacial diseases in clinic, but traditional treatments are unable to restore the structure and function of the injured tissues. Due to their good biocompatibility, biodegradability, antioxidant effect, anti-inflammatory activity, and broad-spectrum antimicrobial property, chitosan-based hydrogels have shown broad applicable prospects in the field of oral tissue engineering. Quaternization, carboxymethylation, and sulfonation are common chemical modification strategies to improve the physicochemical properties and biological functions of chitosan-based hydrogels, while the construction of hydrogel composite systems via carrying porous microspheres or nanoparticles can achieve local sequential delivery of diverse drugs or bioactive factors, laying a solid foundation for the well-organized regeneration of defective tissues. Chemical cross-linking is commonly employed to fabricate irreversible permanent chitosan gels, and physical cross-linking enables the formation of reversible gel networks. Representing suitable scaffold biomaterials, several chitosan-based hydrogels transplanted with stem cells, growth factors or exosomes have been used in an attempt to regenerate oral soft and hard tissues. Currently, remarkable advances have been made in promoting the regeneration of pulp-dentin complex, cementum-periodontium-alveolar bone complex, jaw bone, and cartilage. However, the clinical translation of chitosan-based hydrogels still encounters multiple challenges. In future, more in vivo clinical exploration under the conditions of oral complex microenvironments should be performed, and the combined application of chitosan-based hydrogels and a variety of bioactive factors, biomaterials, and state-of-the-art biotechnologies can be pursued in order to realize multifaceted complete regeneration of oral tissue.

Objectives: Recently, the use of biological synthesis of metal nanoparticles has attracted widespread attention. Researchers are trying to find a biological method to synthesize silver nanoparticles with little environmental pollution and easy preparation, and to explore the impact of preparation conditions on the synthesis of silver nanoparticles. This study aims to explore the biological synthesis of silver nanoparticles (AgNPs) with controllable size and good effect and to compare their biological activity with that of AgNPs prepared by chemical method., Methods: In this study, AgNPs were prepared by biological method with water extract of Tricholomagambosum (WET) and cell-free supernatant of Lactobacillus crispatus (CFS) as reducing agent and protective agent, and silver nitrate solution as precursor. Meanwhile, AgNPs was synthesized by sodium citrate chemical method. The effects of temperature, pH, dosage of extraction solution and light conditions on the biosynthesis of WET-AgNPs and CFS-AgNPs were investigated, and their characteristic of the synthesized WET-AgNPs and CFS-AgNPs were analyzed. Finally, the antibacterial effect, toxicity and selectivity of the 3 different AgNPs were compared., Results: AgNPs were synthesized successfully by the 3 methods with various characteristics. The AgNPs prepared by biological method (WET-AgNPs , CFS-AgNPs) were greatly affected by pH and temperature. The WET-AgNPs and CFS-AgNPs prepared by the biological methods had better antibacterial effect than the AgNPs by the chemical method (all P <0.01). Between them, the WET-AgNPs had a slightly higher antibacterial effect than the CFS-AgNPs. Compared with the AgNPs prepared by chemical method, the toxicity of the WET-AgNPs and CFS-AgNPs to normal cells was lower (both P <0.01), and the cell selectivity of the CFS-AgNPs was better when the concentration was 480 μg/mL., Conclusions: AgNPs with biological activity can be synthesized from WET and CFS, which have different biological activity compared with the AgNPs prepared by biological method.

Early childhood caries (ECC) is the most prevalent chronic oral disease and one of the worldwide public health problems of great urgency for children. ECC can affect children's teeth, dentition, craniomaxillofacial, and general health and development. Therefore, through dental caries etiologies and caries risk assessment, patient-centered, personalized planning and a combination of prevention and treatment should be implemented in the clinical management for ECC. Periodic and continuous cycle management can only be accomplished with the cooperation of medical staff, children, and their guardians. This expert consensus will expound the clinical management of ECC in the following aspects: caries risk assessment, early clinical prevention, treatment strategies, and postoperative management.

Light is the main source for plants to obtain energy.Asarum forbesii is a typical shade medicinal plant, which generally grows in the shady and wet place under the bushes or beside the ditches.It can grow and develop without too much light intensity.This experiment explores the effects of shading on the growth, physiological characteristics and energy metabolism of A.forbesii, which can provide reference and guidance for its artificial planting.In this experiment, A.forbesii was planted under 80%, 60%, 40%, 20% and no shade.During the vigorous growth period, the photosynthetic physiological characteristics such as fluorescence parameters, photosynthetic parameters, photosynthetic pigment content and ultrastructure, as well as the content of mitochondrial electron transport chain(ETC) synthase and nutrients were measured.The results showed that the photosynthetic pigment content, chlorophyll fluorescence parameters and net photosynthesis rate(P&#95;n) decreased with the decrease of shading.Under 20%-40% shading treatment, the plants had damaged ultrastructure, expanded and disintegrated chloroplast, disordered stroma lamella and grana lamella, and increased osmiophi-lic granules and starch granules.The activities of nicotinamide adenine dinucleotide dehydrogenase(NADH), succinate dehydrogenase(SDH), cytochrome C oxidoreductase(CCO) and adenosine triphosphate(ATP) synthasewere positively related to light intensity.With the reduction of shading, the content of total sugar and protein in nutrients increased first and then decreased, and the content was the highest under 60% shade.In conclusion, under 60%-80% shading treatment, the chloroplast and mitochondria had more complete structure, faster energy metabolism, higher light energy-conversion efficiency, better absorption and utilization of light energy and more nutrient synthesis, which was more suitable for the growth and development of A.forbesii.

According to the Chinese Pharmacopoeia(2020 edition), Eupolyphaga Steleophaga is prepared from female Eupolyphaga sinensis. To explore the quality difference between male and female E. sinensis, the present study determined indexes in the Chinese Pharmacopoeia, anticoagulant activity, and content of primary metabolites, amino acids, and trace elements in male and female E. sinensis before and after sexual maturity. The results showed that the content of ash, water, extract, and aflatoxin of the larvae and female adults of E. sinensis met the Chinese Pharmacopoeia standards, while the content of ash and extract of male adults failed to meet the standards. After sexual maturity, the content of water-soluble proteins, crude fat, and extract of female E. sinensis was higher than that of the other three groups(P&lt;0.05). Although the content of total protein, total amino acid(TAA), essential amino acid(EAA), non-essential amino acid(NEAA), branched-chain amino acid(BCAA), functional amino acid(FAA), and delicious amino acid(DAA) of male adults was higher than that of the other groups(P&lt;0.05), the anticoagulant activity was the weakest(P&lt;0.05). Before sexual maturity, the content of Fe in E. sinensis larvae was significantly higher than that in adults(P&lt;0.05). The content of K and Mg in female larvae was the highest, while the content of Ca was the lowest(P&lt;0.05). The content of Cu in male adults was higher than that in the other three groups(P&lt;0.05). In conclusion, except for male adults, the larvae and female adults of E. sinensis meet the Chinese Pharmacopoeia standards. There is no difference in the internal quality of male and female E. sinensis larvae. It is recommended to collect female adults as much as possible. Male adults are rich in proteins and amino acids with high fibrinolytic activities, which can be developed in the future.

The mixed dentition stage is the period between primary and permanent dentition. The following biological processes are complicated and variable: jaw growth, development of inherited permanent teeth embryo, physiological absorption of primary teeth, restoration of surrounding alveolar bones, and growth and function establishment of soft tissues. For the normal development of the jaw, the establishment of the good occlusion relationship, development, and function of soft tissue is very important, whether or not the primary teeth are normally replaced by the permanent teeth in the mixed dentition stage. The eruption space is linked to the normal replacement of primary and permanent teeth. The presence of a mixed dentition space results in the incidence and progression of malocclusion and impacts the normal growth and development of the occlusion, jaw, and face. Space management in the mixed dentition stage is a crucial means to prevent and reduce malocclusion. The following were discussed and analyzed: the possible space problems, why the size of the space was affected, the content that needs to be assessed, and the methods of space management in the mixed dentition that can be used to unify and standardize the management of mixed dentition. This paper was developed to serve as a guide for regulated space management during the mixed dentition period.

In the field of oil and gas exploration and development, the quick identification of reservoir crude oil properties has a guiding significance for engineers and technicians. Geochemical logging technology is a conventional method to evaluate the properties of crude oil in reservoirs, and it can provide professional knowledge for comprehensive evaluation of reservoirs. In this study, the principles of rock pyrolysis and gas chromatographic analyses in geochemical logging are studied. Moreover, a new method for quantitative analysis of crude oil density by chromatogram is proposed. Combined with the division standard of crude oil property density, the properties of reservoir crude oil can be quickly evaluated. In the experiment, first, the chromatogram was standardized and normalized using computer image processing software. The curve characteristic law of rock pyrolysis gas chromatogram was analyzed, and the corresponding characteristic parameter extraction method was proposed. The chromatogram was converted into a characteristic parameter matrix. Second, three types of artificial intelligence prediction and classification models were studied. The latest meta-heuristic optimization algorithm (sparrow search optimization algorithm) was used to optimize the hyperparameters of the generalized regression neural network, and the accuracy and convergence speed of the model were improved. To study the influence of different positions of rock samples on the experimental results, two groups of samples were utilized: cuttings samples and wall core samples. Based on a comprehensive comparison of the prediction results of the three models, it was found that the generalized regression neural network prediction model optimized by sparrow search algorithm provided the best effect, being a stable model, with small prediction density error, and strong generalization ability. The prediction error coincidence rate (absolute error < 0.02) of this model for cuttings and wall core samples was 95% and 100%, respectively. The root mean square errors were 0.0079 and 0.0069 respectively. The classification accuracy of crude oil properties was 95%. The analysis of the two groups of parallel experimental data indicated that the rock samples from the wall center can more accurately reflect the crude oil properties of the reservoir. Therefore, the method proposed in this study can provide reliable data support for reservoir comprehensive evaluation and on-site construction.

Objective: To investigate the surgical skills and clinical curative results of arthroscopic treatment of ankle instability combined with anteromedial impingement syndrome., Methods: From February 2019 to August 2020, 13 patients with ankle instability combined with anteromedial impingement were retrospectively analyzed. There were 10 males and 3 females with age of (40.0±15.1) years old. The course of disease was(44.1±33.2) months. All patients had history of ankle sprain. MRI showed the injury of anterior talofibular ligament. All patients had anteromedial pain and pressing pain when ankle dorsiflexion. All patients were treated with ankle debridement and Brostr?m-Gould surgery under ankle arthroscopic. Postoperative results were evaluated by VAS(visual analogue scale) and AOFAS-AH(American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale, AOFAS-AH)., Results: All 13 patients completed the surgery successfully with an operative time of 60 to 90 minutes. All the surgical incisions healed by first intention, and no complications such as incision infection, skin necrosis and neurovascular injury. Follow-up time was (18.1±4.7) months. At the latest follow-up, the VAS score was 1.2±1.1, which was significantly lower than the preoperative score 4.8±1.5 ( P <0.05);the AOFAS-AH score 94.2±5.1 was significantly higher than the preoperative score 65.5±11.5 ( P <0.05). The AOFAS-AH score at the final follow-up ranged from 84 to 100. All patients walked with normal gait without ankle instability or impingement recurrence., Conclusion: Ankle anteromedial impingement syndrome combined with ankle instability is easy to be ignored clinically. Such kind of anteromedial impingement syndrome is mostly related to osteophyte at dorsal medial talar neck. Arthroscopic treatment of ankle instability combined with anteromedial impingement syndrome has satisfactory curative effect with safety and minimal injury.

Objectives: This study aimed to establish a Chinese version of the Child Perceptions Questionnaire for children aged 8-10 years (CPQ 8-10 ) and evaluate its reliability and validity for a comprehensive and reliable assessment of oral health-related quality of life in children., Methods: The Chinese CPQ 8-10 was formed through translation, reverse translation, and cross-cultural adaption according to international standard procedures. It was used to evaluate the children's oral health-related quality of life to assess the reliability and validity of the scale., Results: A total of 446 children received the survey, and 405 valid questionnaires were obtained. Cronbach's a for the full scale was 0.87, and the intraclass correlation coefficient for the total scale was 0.88. The CPQ 8-10 score was significantly correlated with the score of two global questions ( P <0.01). The dental caries group had the highest score of the full scale, followed by the malocclusion group; the healthy group had the lowest score ( P <0.01)., Conclusions: The Chinese version of CPQ 8-10 demonstrates great reliability and validity and provides a theoretical basis for its application in Chinese children aged 8-10 years.

Objective: To analyze the clinical features and variants of ABCD1 gene in a Chinese pedigree affected with X-linked adrenoleukodystrophy., Methods: Clinical data of the proband were collected and analyzed. Potential variant of the ABCD1 gene were analyzed by PCR and Sanger sequencing of the proband, his parents and 100 unrelated healthy individuals., Results: The prominent features of the proband included cerebellar and brainstem lesions, along with increased serum level of very-long chain fatty acids. He was found to harbor a hemizygous c.1509delG (p.L504Sfs*54) variant of the ABCD1 gene, for which his mother was heterozygous. The same variant was not detected in his father and 100 healthy controls., Conclusion: X-linked adrenoleukodystrophy has a variety of clinical manifestations. Discovery of the c.1509delG (p.L504Sfs*54), as a novel pathogenic variant of the ABCD1 gene, has enabled diagnosis and genetic counseling for this pedigree.

This study investigated the effect of rhein(RH) on the apoptosis and autophagy of human umbilical vein endothelial cells(HUVECs) induced by hydrogen peroxide(H&#95;2O&#95;2) and its underlying mechanism. The oxidative damage model in HUVECs was established and the cells were divided into different treatment groups. Cell survival rate was detected by MTT assay, apoptosis by Annexin V-FITC/PI double staining and Hoechst 33258 fluorescence staining, autophagy by Ad-mCherry-GFP-LC3 B adenovirus transfection, and protein expression by Western blot. The results showed that RH could protect cells by increasing the cell survival rate in a dose-dependent manner, decreasing the expression of apoptosis-related proteins(Bax and cleaved caspase-3) and the ratio of Bax/Bcl-2, elevating the expression of Bcl-2, up-regulating the expression of microtubule-associated protein 1 light chain 3(LC3)-Ⅱ, and down-regulating the expression of p62. Adenovirus transfection results showed that RH could increase the green and red spots, as well as the yellow spots. However, after the addition of autophagy inhibitor 3-MA, autophagy was reduced and apoptosis was increased. RH could enhance the expression of silent information regulator 2 related enzyme 1(SIRT1). The addition of SIRT1 inhibitor EX-527 reduced the protective effect of RH and cell viability. The addition of 3-MA had no effect on the expression of SIRT1 protein, but the expression of SIRT1 and LC3-Ⅱ proteins decreased and the expression of p62 increased after the addition of EX-527. After RH treatment, the phosphorylation of adenosine monophosphate-activated protein kinase(AMPK) increased, while that of the mechanistic target of rapamycin(mTOR) decreased in a dose-dependent manner. Moreover, this effect could be weakened by the AMPK inhibitor compound C. RH may enhance autophagy through SIRT1/AMPK/mTOR pathway to reduce H&#95;2O&#95;2-induced apoptosis of HUVECs.

Objectives: To evaluate the efficacy and health economics of the comprehensive therapy for the children with severe early child caries (S-ECC) under dental general anesthesia (DGA) and conventional outpatient treatment to provide references for dentists and parents in the choice of clinical treatment., Methods: A retrospective cohort study was conducted on S-ECC children aged 36-71 months and who received dental treatment under general anesthesia or routine outpatient situation. The filled tooth survival rate, treatment cost, and cost-filled tooth survival time of the two groups were compared, and the curative effect and health economics was evaluated., Results: The filled tooth survival rate of the DGA group was higher than that of the routine outpatient group ( P <0.05). The average direct medical cost per filled tooth was significantly higher in the DGA group than in the routine outpatient group ( P <0.05). The direct medical cost-filled tooth survival time ratio in the DGA group was higher than that in the routine outpatient group ( P <0.05), but no significant difference was observed in the total medical cost-filled tooth survival time ratio ( P >0.05)., Conclusions: Compared with the conventional outpatient treatment group, the treatment outcomes of S-ECC under general anesthesia were better, and the costs were higher. However, no significant difference was observed in the total medical cost-filled tooth survival time between these two groups, and the conventional outpatient treatment did not have evident economic advantages.

Combined with the clinical use condition of MR in use in Shanghai Sixth People's Hospital, MR components are divided into scanning type I and scanning type II. At the same time, combined with the main loss force of MR components, the research divides MR components into dynamic components and electric thermal components. In this study, a complete set of MR system reliability indexes and implementation methods are given, including system reliability index determination, system reliability allocation, component reliability index realization, system reliability prediction and system reliability verification. At the same time, this study also gives the methods of reliability prediction and reliability verification, and gives the MTBF calculation method of MR system based on clinical use data statistics.

Objective: To investigate the effect and mechanism of PPAR-γ agonist Pioglitazone (PGZ) on the proliferation of malignant mesothelioma (MM) cells. Methods: In December 2019, MM cell lines MSTO-211H and NCI-H2452 were incubated with different final concentrations of PGZ (0, 10, 50, 100, 150, and 200 μmol/L) for different periods of time (24 h, 48 h, and 72 h) , and then the cell proliferation level was detected by CCK8 assay. After given various final concentration of PGZ (0, 10, 50, 100, 150, 200 μmol/L) the for 72 hours, the changes of number and morphology of MM cells were observed under an inverted microscope. The expressions of PPAR-γ and HMGB1 mRNA were determined by real-time fluorescence quantitative reverse transcription-polymerase chain reaction (qRT-PCR) after treatment of MM cells with PGZ of 0, 10, 50, 100 μmol/L for 72 h. The MM cells were treated with PGZ at concentration of 0, 100 μmol/L for 72 h, and the protein expressions of HMGB1 were examined using Western blotting and immunofluorescence; the protein expressions of Ki67 were assessed by immunohistochemistry. Results: The cell viability rate of MM cells was decreased after treated with PGZ ( P <0.05) . Cell number in PGZ-treated group was significantly less than that in control group and morphology changes were observed under light microscope. QRT-PCR results revealed significantly increased PPAR-γ mRNA expression in the PGZ-treated group compared to the control group ( P <0.05) . There was a significant decrease in the mRNA expression level of HMGB1 in the PGZ-treated group (100 μmol/L) as compared to the control group in MSTO-211H ( P <0.05) ; however, the expression level of HMGB1 in NCI-H2452 was an increase or no significant differences ( P >0.05) . Western blotting and immunofluorescence results showed that the protein expression of HMGB1 was reduced in the PGZ-treated group compared with the control group in MSTO-211H ( P <0.05) , but the protein expression of that in NCI-H2452 was no significant differences ( P >0.05) . Immunohistochemistry results showed increased expression of proliferation marker Ki-67. Conclusion: Pioglitazone suppresses the proliferation of MM cells through inhibition of HMGB1 by the activation of PPAR-γ.

In this study, through the analysis of the composition of domestic large radioactive medical equipment PET/CT and the characteristics of each subsystem, combing the vulnerable spots, according to the standard requirements of PET/CT for 10 years in its service life, we research the PET/CT service life's effectiveness. Firstly, this study introduces the concept of service life, the relationship between service life and risk analysis, the pivotal system composition of PET/CT, the importance of reliability of each component, the traditional test method to verify its reliability is researched. This study suggests a test procedure and method to prove the reliability of various components of PET/CT equipment during the service life. This method is described in detail, and the specific test process in practical engineering application is discussed, which proves that it is beneficial to ensure the effectiveness of PET/CT during the service life.

Based on the clinical application data of medical X-ray computed tomography (CT) in the Shanghai Sixth People's Hospital, this study transformed it into the product reliability index requirements, and took the mechanical representative component-examination table (hereinafter referred to as "patient table") and the electronic representative component-DCB (data control board) as examples. Based on the relationship between failure characteristics and clinical application data, a complete set of closed-loop implementation methods from reliability index requirements to reliability design and verification are discussed.

Objective: To investigate the effect and safety of Escherichia coli ( E.coli ) expressing gas vesicle (GVs) for enhancing the efficacy of tumor ablation by high intensity focused ultrasound (HIFU) in tumor-bearing mice., Objective: Thirty-two female BALB/c mice were used to establish mouse models bearing 4T1 tumor, which were randomized into GVs group [ E.coli BL21 (AI)-PET28a-Arg1] and control group (PBS), and the efficacy of HIFU ablation was evaluated by examining coagulative necrotic volume and pathology of the tumors. Another 104 BALB/c mice were also randomly divided into GVs group and control group, and body weight changes of the mice were recorded on days 1, 4 and 15 after intravenous injection of E.coli containing GVs or PBS. White blood cells, red blood cells, hemoglobin and platelet counts and liver and renal function parameters of the mice were detected, and serum levels of TNF-α and IL-1β were examined using ELISA. The pathological changes in the liver and spleen were evaluated using HE staining to assess the safety of the treatments., Objective: HIFU ablation resulted in a significantly greater volume of coagulative necrosis and severer tissue damage in GVs group than in the control group ( P < 0.001). In the 104 BALB/c mice without tumor cell inoculation, intravenous injection of E.coli expressing GVs, as compared with PBS, did not significantly affect body weight or cause changes in white blood cell, red blood cell and platelet counts or hemoglobin level ( P 1=0.59, P 2=0.27, P 3=0.76, P 4=0.81). The liver and kidney function parameters ( P 1=0.12, P 2=0.46, P 3=0.62, P 4=0.86) and serum levels of TNF-α and IL-1β ( P 1=0.48, P 2=0.56) were all comparable between GVs group and control group. No obvious pathological changes were detected in the liver and spleen tissues in either GVs group or the control group., Objective: E.coli expressing GVs is safe for enhancing the ablation effect of HIFU in tumor-bearing mice.

Objective: To analyze the risk factors for postoperative mortality of the elderly patients with femoral neck fracture undergoing hemiarthroplasty., Methods: Patients who underwent hemiarthroplasty for femoral neck fractures between January 2011 and December 2015 were enrolled as object. One hundred and nine patients who met the selection criteria were included in the study, and the clinical data were collected, including gender, age, time from admission to surgery, comorbidities, and preoperative hemoglobin level and nutritional status. Univariate analysis and Cox proportional hazard regression model were used to screen the risk factors for postoperative mortality., Results: The 1-year and 2-year mortalities were 6.4% (7/109) and 17.4% (19/109), respectively. Univariate analysis showed that the age, preoperative hemoglobin level and nutritional status were the influencing factors of postoperative mortality in the elderly patients with femoral neck fractures treated with hemiarthroplasty ( P <0.05). Multivariate analysis showed that the age≥80 years and malnutrition were the independent risk factors for postoperative mortality ( P <0.05)., Conclusion: To improve the clinical outcomes, perioperative risk should be comprehensively evaluated by multidisciplinary and perioperative management should be strengthened in the elderly patients with femoral neck fracture, especially those with advanced age and malnutrition, for the high postoperative mortality.

Objective: The aim of this study is to investigate the effect of smoking on the glucose, lipid metabolism and sleep structure in patients with moderate and severe obstructive sleep apnea （OSA） after operation. Methods: A retrospective analysis of 103 adult male patients with moderate to severe OSA who were diagnosed and treated from January 2016 to December 2017. All of them could not tolerate continuous positive pressure ventilation. After evaluation by an otolaryngologist, they underwent modified uvulapalatopharyngoplasty surgery. All participants were grouped according to smoking status（non-smokers, smokers） for analysis. Laboratory-based polysomnographic variables, anthropometric measurements, biochemical indicators, and smoking history, Epworth sleepiness score（ESS） were collected preoperatively and postoperatively. And the difference of each variable preoperatively and postoperatively was demonstrated as delta（Δ, calculated as postoperative value minus preoperative value）. Results: Fifteen patients with preoperative moderate OSA and 88 patients with severe OSA. The overall successful rate of surgery was 55.3%（18.4% cured, 23.3% markedly effective and 13.6% effective）, and there was no statistical difference between the non-smokers and the smokers（59.7% vs 48.9%, P =0.276）. After surgery, AHI, mean oxygen saturation, ODI, MAI, TC, FBG, fasting insulin, BMI, ESS, N1 and N3 were significantly improved（ P <0.05）. The amelioration of glucose or lipid metabolism related traits（including ΔTC, ΔFBG, Δfasting insulin） were not significantly different between smokers and non-smokers. However, as to sleep structure, ΔN3 was significantly higher in non-smoker as compared to smokers（ P =0.039）. Conclusion: Upper airway surgery is helpful to improve the glucose and lipid metabolism disorder and sleep structure in OSA patients. Postoperative smoking was associated with worse sleep structure, but not glycolipid metabolism. The postoperative improvement of sleep structure in non-smoking OSA patients was better than smokers., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

According to the actual requirements of pediatric intensive care, a suction detection system of pediatric oral secretions integrated with monitoring function is designed. The system has the function of adjustable intermittent attraction. The duration and proportion of intermittent attraction can be adjusted according to the individualized needs of pediatric intensive care. The suction head of pacifier can reduce the mechanical damage to pediatric oral mucosa as much as possible. Meanwhile, the system can detect and monitor the real-time biochemical indexes of the collected oral secretions, which can be used to help the judgement of aspiration and quantitatively evaluate the microcirculation dysfunction.

Abstract: Objective To establish the orthogonal partial least square （OPLS） model for the estimation of early postmortem interval （PMI） of asphyxial death rats in four ambient temperatures based on gas chromatography-mass spectrometry （GC-MS） metabolomics. Methods The 96 rats were divided into four temperature groups （5 ℃, 15 ℃, 25 ℃ and 35 ℃）. Each temperature group was further divided into 3 h, 6 h, 12 h and 24 h after death, and 6 other rats were taken as the control group. The cardiac blood was collected at the set time points for the four temperature groups and 0 h after death for the control group for the metabolomics analysis by GC-MS. By OPLS analysis, the variable importance in projection （VIP）>1 and the result of Kruskal-Wallis test P<0.001 were used to screen out the differential metabolite related to PMIs in the cardiac blood of rats of different temperature groups. Then OPLS regression models of different temperature groups were established with these metabolites. At the same time, a prediction group for investigating the prediction ability of these models was set up. Results Through the analysis of OPLS, 18, 15, 24 and 30 differential metabolites （including organic acids, amino acids, sugars and lipids） were screened out from the rats in groups of 5 ℃, 15 ℃, 25 ℃ and 35 ℃, respectively. The prediction results of the four temperature group models showed that the prediction deviation of 5 ℃ model was larger than that of other groups. The prediction results of other temperature groups were satisfactory. Conclusion There are some differences in the changes of metabolites in cardiac blood of rats at different ambient temperatures. The influence of ambient temperature should be investigated in the study of PMI estimation by metabolomics, which may improve the accuracy of PMI estimation., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Forensic Medicine.)

Objective: To investigate the treatment efficacy of electronic endoscope-Guided botulinum toxin injection in Adductor Spasmodic Dysphonia Patients. Method: Clinical characteristics of forty- three cases were retrospectively analyzed. The disease were diagnosed with adductor spasmodic dysphonia and graded according to the severity of the disease by experienced voice specialist. All the cases were treated by electronic endoscope-guided botulinum toxin type A injection in bilateral thyroarytenoid muscles. All the subjects underwent stroboscopic laryngoscope examination and filled in the Voice Handicap Index-10（VHI-10）. They also filled in the VAS score of Voice related symptoms by self evaluation and other evaluation . One month Later, the patients and someone they lived with filled in the VAS score of Voice related symptoms again. Result: After the first injection, the voice-related symptoms of 35 patients improved to varying degrees..All The average onset time of drug was（2.33±1.86） days. The duration of curative effect ranged from 1 to 6 months, the average duration was（2.42±1.65） months. After injection, no one had serious or persistent adverse reactions. There were significant differences in the total score of VHI-10, physiology（P） and function（F） dimensions in VHI-10 of moderate and severe SD patients before and after injection（ P <0.05） in all patients. For moderate cases, no significant change in speech articulation（ P >0.05）, overall evaluation of voice quality and any other subprojects are statistically significant（ P <0.05） in the VAS score of Voice related symptoms; For severe cases, the degree of squeezing and effort during vocalization are no statistically significant（ P >0.05）, overall evaluation of voice quality and any other subitems are statistically significant（ P <0.05） in the VAS score of Voice related symptoms. Conclusion: In the absence of LEMG, electronic endoscope-guided botulinum toxin injection in adductor spasmodic dysphonia patients can significantly improve the voice quality and quality of life of adductive SD patients. The method is simple to operate, less traumatic, safe and effective, and easy to carry out outpatients service., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To compare the caries experience and the kinds of dental treatment between children with autism spectrum disorders (ASD) and children without systemic disease who were all treated under general anesthesia. Methods: Totally 103 children with ASD who received dental treatments under general anesthesia in 13 professional dental hospitals around China from April to November 2016 were included in the present study. A group of 97 children without systemic disease, according to the age, gender and application propensity score matching method, were chosen as controls, who received dental treatments under general anesthesia between January 2015 to November 2018 in the same hospitals as the children with ASD. Decay missing filling tooth (DMFT/dmft, DMFT for permanent teeth and dmft for primary teeth) indices of two groups of children and the contents of the dental treatments under general anesthesia were analyzed. Results: No significant difference of DMFT/dmft index ［ M ( Q 25 , Q 75 )］ was found between children with ASD group ［0 (0, 3)/11(8, 14)］ and control group ［0 (0, 3)/9(7, 13)］ ( P >0.05). The average number of dental treatments under general anesthesia and the average number of endodontic treatment in children with ASD were 13 (11, 15) and 3 (2, 6) teeth respectively, while those in the control group were 12 (9, 14) and 2 (1, 4) teeth respectively, the differences were statistically significant ( P <0.01, P <0.05). Conclusions: No significant difference was found between children with ASD and the normal controls who receive dental treatments under general anesthesia in DMFT/dmft index, but the treatment needs of children with ASD is relatively higher, and their tooth decay is relatively severer.

Severe congenital neutropenia is a rare disorder characterized by a consistently low absolute neutrophil count and periodontal disease. This report describes the case of an ELANE mutationin a patient with gingival bleeding and tooth mobility. Oral examination showed active periodontal infection of the primary dentition accompanied by alveolar bone loss in the posterior region. The patient was diagnosed with severe congenital neutropenia 1 year after multidisciplinary consultation. Treatment of the systemic disease and effective oral health education over a 3-year follow-up period relieved the periodontal infection and created favorable conditions for future repair.

The purpose of this study is to provide a culture for mouse bone marrow-derived macrophages (BMDM) and peritoneal macrophages (PM) and to characterize their molecular and cellular biology. The cell number and purity from the primary culture were assessed by cell counter and flow cytometry, respectively. Morphological features were evaluated by inverted microscope. Phagocytosis by macrophages was detected by the neutral red dye uptake assay. Phenotypic markers were analyzed by real-time fluorescent quantitative PCR. Our results show that the cell number was much higher from culture of BMDM than PM, while there was no significant difference regarding the percentage of F4/80+CD11b+ cells (98.30%±0.53% vs. 94.83%±1.42%; P>0.05). The proliferation rate of BMDM was significantly higher than PM in the presence of L929 cell conditioned medium, by using CCK-8 assay. However, PM appeared to adhere to the flask wall and extend earlier than BMDM. The phagocytosis capability of un-stimulated BMDM was significantly higher than PM, as well as lipopolysaccharide (LPS)-stimulated BMDM, except the BMDM stimulated by low dose LPS (0.1 μg/mL). Furthermore, Tnfα expression was significantly higher in un-stimulated BMDM than PM, while Arg1 and Ym1 mRNA expression were significantly lower than PM. The expression difference was persistent if stimulated by LPS+IFN-γ or IL-4. Our data indicate that bone marrow can get larger amounts of macrophages than peritoneal cavity. However, it should be aware that the molecular and cellular characteristics were different between these two culture systems.

Objective: To compare the effect of impulse-radio ultrawideband（IR-UWB） radar technology and polysomnography（PSG） in sleep assessment. Method: A total of 79 OSA patients were randomly divided into two groups: 40 patients in group A received PSG and IR-UWB, and 39 patients in group B received micromovement sensitive mattress（MSM） and IR-UWB. Pearson correlation and ROC curve were used for statistics. Result: AHI PSG and AHI MSM were significantly correlated with AHI IR-UWB（ r =0.91, P ＝0.00; r =0.92, P ＝0.00）. Bland-Altman analysis showed that AHI IR-UWB value was highly consistent with AHI PSG value（95.00%）, and AHI IR-UWB value（97.44%）. The sensitivity and specificity of AHI IR-UWB compared with PSG were 70.40% and 89.90%, respectively. The area under ROC curve was 0.915. Conclusion: IR-UWB has a high diagnostic value for adult OSA in terms of minimum blood oxygen saturation, average blood oxygen saturation, average number of central sleep apnea, average number of complex sleep apnea, average heart rate, sleep efficiency, REM sleep duration, average AHI, etc. It is an economic and practical sleep evaluation tool., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objectives: To evaluate the response to cardiac resynchronization therapy (CRT) and the correlation between CRT and pulmonary artery hemodynamic parameters., Methods: The patients with chronic heart failure indicator for CRT were enrolled. The left ventricular end-systolic volume (LVESV) was measured by echocardiography and New York Heart Association (NYHA) classification was evaluated between one week before and six months after CRT. Mean pulmonary artery pressure (mPAP), pulmonary artery systolic pressure (PASP) and pulmonary vascular resistance (PVR) were measured by right heart catheterization. Left ventricular reverse remodeling (LVRR) is defined as a decrease of 15% or more in LVESV at the 6th month after CRT; Clinical response is defined as a decrease of NYHA classification at or above grade 1 at the 6th month after CRT. Pulmonary hypertension (PH) was defined as mPAP≥25 mmHg. According to the response, patients were divided into 3 groups: group A (LVRR+clinical response), group B (no LVRR+clinical response) and group C (no LVRR+no clinical response). The changes of NYHA classification, echocardiographic and pulmonary hemodynamic parameters were observed in the 3 groups. The Kaplan-Meier survival curve was used to analyze the differences in all-cause mortality, combined end-point events of death or re-hospitalization due to heart failure among different groups., Results: A total of 45 patients with CRT implantation [aged (63.27±9.55) years, 36 males] were included. The average follow-up period was (33.76±11.50) months. Thirty-one patients (68.89%) were in group A, 9 of whom with PH. Eight patients (17.78%) were in group B, 7 of whom with PH. Six patients were in group C, all with PH. Cardiac function including NYHA classification, echocardiographic and pulmonary hemodynamic parameters had been significantly improved in group A after CRT implantation ( P <0.05). In group B, NYHA classification and pulmonary hemodynamic parameters were decreased significantly ( P <0.05), but echocardiographic parameters did not change obviously ( P >0.05). There were no significant changes in NYHA classification, echocardiographic and pulmonary hemodynamic parameters in group C ( P >0.05). Compared with group C, group A and group B had lower all-cause mortality ( P =0.005) and lower incidence of composite endpoint events ( P =0.001)., Conclusions: Patients with LVRR and clinical response after CRT have a good prognosis. Patients with clinical response but without LVRR have a better prognosis than those without clinical response and LVRR, which may be related to the decrease of pulmonary hemodynamic parameters such as mPAP and TPG.

Objective: This study aimed to evaluate the postoperative complications undergoing dental general anesthesia in children and analyze the prevalence and related factors., Methods: This prospective study involved 292 systematically healthy children (36 to 71 months old) who received extensive dental treatment under general anesthesia. Data about patients' histories, characteristics, dental and anesthesia procedure were collected. Parents or caregivers were interviewed face to face preoperation and 72 h postoperation. Data were analyzed using logistic regression., Results: Approximately 93.5% of the enrolled children reported one or more complications. The most prevalent complication was postoperative pain, followed by weariness, agitation, problem in eating, drowsiness, oral bleeding, cough, fever, etc. The length of operative time and femininity were the risks of the postoperative pain. Nutrition status was the factor probably in association with fever., Conclusions: The children receive longer operative time and girls show to be more susceptible to the postoperative pain. High nutrition status could be the protective factor of postoperative fever.

Objective: To explore the patient-ventilator interaction of neurally adjusted ventilatory assist (NAVA) in patients with severe neurological diseases., Methods: A prospective study was conducted. Sixteen severe neurological patients with tracheotomy admitted to neurosurgery intensive care unit (NSICU) of Yijishan Hospital of the First Affiliated Hospital of Wannan Medical College from September 2019 to February 2020 were enrolled. According to the random number table method, they were treated with pressure support ventilation (PSV) mode followed by NAVA mode or NAVA mode followed by PSV mode mechanical ventilation. Each mode was ventilated for 24 hours. The number of auto-triggering, ineffective trigger, double trigger, inspiratory trigger delay, premature cycling, late cycling, and patient-ventilator asynchronous time (inspiratory trigger delay time, premature cycling time, and late cycling time) within 1 minute were recorded every 8 hours for 3 minutes. The average number of asynchronies per minute, asynchrony index (AI), total AI, asynchrony time, arterial blood gas analysis, and coefficient variation (CV%) of respiratory mechanics parameters of each asynchrony type between the two modes were compared., Results: There were significant decrease in the number or AI of auto-triggering, ineffective trigger, inspiratory trigger delay, premature cycling, and late cycling with NAVA mode ventilation compared with PSV mode ventilation [auto-triggering times (times/min): 0.00 (0.00, 0.00) vs. 0.00 (0.00, 0.58), auto-triggering AI: 0.00 (0.00, 0.00) vs. 0.00 (0.00, 0.02), ineffective trigger times (times/min): 0.00 (0.00, 0.33) vs. 1.00 (0.33, 2.17), ineffective trigger AI: 0.00 (0.00, 0.02) vs. 0.05 (0.02, 0.09), inspiratory trigger delay times (times/min): 0.00 (0.00, 0.58) vs. 0.67 (0.33, 1.58), inspiratory trigger delay AI: 0.00 (0.00, 0.02) vs. 0.05 (0.02, 0.09), premature cycling times (times/min): 0.00 (0.00, 0.33) vs. 0.33 (0.08, 1.00), premature cycling AI: 0.00 (0.00, 0.01) vs. 0.02 (0.00, 0.05), late cycling times (times/min): 0.00 (0.00, 0.00) vs. 1.17 (0.00, 4.83), late cycling AI: 0.00 (0.00, 0.00) vs. 0.07 (0.00, 0.25), all P < 0.05]. But there was significant increase in the number or AI of double trigger with NAVA mode ventilation as compared with PSV mode ventilation [times (times/min): 1.00 (0.33, 2.00) vs. 0.00 (0.00, 0.00), AI: 0.04 (0.02, 0.11) vs. 0.00 (0.00, 0.00), both P < 0.05]. Total AI and incidence of total AI > 0.1 showed significant decrease during NAVA mode ventilation as compared with PSV mode ventilation [total AI: 0.08 (0.04, 0.14) vs. 0.22 (0.18, 0.46), incidence of total AI > 0.1: 37.50% (6/16) vs. 93.75% (15/16), both P < 0.01]. There was no significant difference in asynchronous time or arterial blood gas analysis between the two modes. There were significant increases in variances of peak airway pressure (Ppeak) and expiratory tidal volume (VTe) during NAVA mode ventilation as compared with PSV mode ventilation [Ppeak coefficient of variation (CV%): 11.25 (7.12, 15.17)% vs. 0.00 (0.00, 2.82)%, VTe CV%: (8.93±5.53)% vs. (4.71±2.61)%, both P < 0.05]., Conclusions: Compared with PSV mode, NAVA mode can reduce the occurrence of patient-ventilator asynchronous events, reduce the AI and the occurrence of serious patient-ventilator asynchronous events, so as to improve the patient-ventilator interaction. NAVA and PSV modes can achieve the same gas exchange effect. At the same time, NAVA mode has potential advantages in avoiding insufficient or excessive ventilation support, diaphragm protection and prevention of ventilator-induced lung injury.

Objective: To investigate the effectiveness of concealed penis correction surgery based on the principle of midline symmetry., Methods: Between January 2016 and September 2018, 18 children with concealed penis were treated with correction surgery based on the principle of midline symmetry. All children were 3-12 years old, with an average age of 8.3 years. Physical examination showed that the penis was short; the penis body could not be exposed or be exposed too limited; the corpus cavernosum developed well. The pressure dressing was removed at 3 days after operation and the urethral tube was removed. The color of the glans, the swelling and congestion of penis and scrotum, and the blood supple of the prepuce flap were observed., Results: The operation time ranged from 47 to 54 minutes, with an average of 50 minutes. All children were followed up 3 months after operation. There was no hemorrhage and necrosis of the glans and no infection or ischemic necrosis of the flap. All patients had different degree of prepuce edema at 3 days after operation, 5 patients still had prepuce edema at 2 weeks, and the prepuce edema in all patients subsided at 3 months. All penises were exposed well after midline symmetric anastomosis with no bulky prepuce and scrotum., Conclusion: The correction surgery based on the principle of midline symmetry can be used to correct the appearance of the concealed penis effectively.

This study mainly discusses the contents, methods and characteristics of the collection of operation and maintenance data, as well as the establishment and evaluation methods of the distribution model of the failure time of medical electrical equipment. The distribution models of failure time at three levels of medical electrical equipment are established by linear regression method and goodness of fit test:The first is the device level MTBF distribution model, the second is the failure rate distribution model of the failure mode of key components, the third is the calculation model of the influence coefficient of influence factor on the failure mode of key components. This study presents a method of establishing MTBF segment model and implements a calculation model of influence coefficient varying with time.

Coronavirus disease 2019 (COVID-19) is becoming a major public health event affecting China and even the whole world. During the epidemic period of corona virus disease, appropriate oral health management and disease prevention of children is very important for children's oral and general health. In order to prevent the occurrence of cross-infection and epidemic spreading of COVID-19 during dental practice, the recommendations to parents include: not only training children to maintain hand hygiene at home, exercise appropriately, strengthen physical resistance, but also helping children develop good oral and diet habit such as effective brushing and flossing to avoid oral diseases and emergency. If non-emergency oral situation occur, parents could assist their child to take home based care such as rinsing to relieve the symptoms. When oral emergencies such as acute pulpitis, periapical periodontitis, dental trauma, oral and maxillofacial infections happen, parents and children should visit dental clinic in time with correct personal protection. During the epidemic period, children's oral emergencies should be treated in accordance with current guidelines and control of COVID-19., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).)

Objective: To carry out genetic testing and prenatal diagnosis for 90 families affected with spinal muscular atrophy (SMA), and discuss the necessity for carrier screening., Methods: All families were subjected to multiplex ligation-dependent probe amplification (MLPA) analysis. Combined MLPA and allele-specific PCR (AS-PCR) was used for prenatal diagnosis of the pregnant women., Results: Among the 90 couples, 84 (93%) had a negative family history, 85 (94%) had given birth to an affected child before. Eighty-five husbands and 88 wives carried heterozygous deletion of exon 7 of the SMN1 gene. Two wives had homozygous deletion of exon 7 of the SMN1 gene and were affected. Prenatal diagnosis showed that 19 fetuses were SMA patients, 48 fetuses were carriers, and 23 fetuses were normal. Of note, eighteen affected fetuses were conceived by couples without a family history, which accounted for 20% of all pregnancies and 95% of all affected fetuses., Conclusion: To screen SMA carriers using MLPA and carry out prenatal diagnosis using combined MLPA and AS-PCR can ensure accurate diagnosis, which has a significant value for the prevention of SMA affected births.