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Abstract The goal of this study was to compare the advantages of conventional laparoscopic surgery (CLS) and the split-leg supine position single-port plus one laparoscopic surgery (SSP SILS + 1) in esophageal surgery. This study enrolled 73 patients who previously underwent radical esophagectomy for esophageal cancer from August 2021 to February 2023. Among them, 36 patients underwent SSP SILS + 1, whereas the remaining 37 patients underwentCLS. Surgical time, bleeding volume, number of dissected lymph nodes, incision length, and postoperative abdominal pain score between the two groups of patients were compared using either the Student’s t-test or chi-square test. Time of abdominal incision (1.4 ± 0.2 min vs. 5.2 ± 0.7 min, p 0.01) between the two groups. The SSP SILS + 1 intervention offers multiple benefits over conventional surgical procedures, encompassing shorter incision length and pain scores on POD 1. In accelerated rehabilitation surgery for esophageal cancer, this surgical procedure demonstrated high safety, feasibility.

Autologous hematopoietic stem cell transplantation (auto-HSCT) is considered optional consolidation therapy especially for relapsed/refractory extranodal NK/T-cell lymphoma (ENKL), but its applications to newly diagnosed advanced-stage ENKL is currently limited.

Objective·To investigate the expression and clinical significance of geranylgeranyl diphosphate synthase1 (GGPS1) in lung squamous cell carcinoma (LUSC) by bioinformatics and immunohistochemistry.Methods·Firstly, the transcriptome data of LUSC tissues and paired normal tissues were downloaded from UCSC Xena platform. The data were standardized and differentially expressed by R language, and verified by UALCAN database. UALCAN and LinkedOmics databases were used to analyze the relationship between GGPS1 expression and clinicopathological features in LUSC patients. The Kaplan-Meier Plotter database was used to explore the effect of GGPS1 expression on prognosis in LUSC patients. The least absolute shrinkage and selection operator (LASSO) regression analyses were applied to screen gene correlation coefficients and risk scores. The diagnostic value of GGPS1 for LUSC was evaluated by nomogram and calibration curve. The protein-protein interaction (PPI) network of GGPS1 was constructed by using STRING and GeneMANIA databases. R language was used to select the differential genes related to GGPS1, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed. The expression of GGPS1 in LUSC patients was detected by immunohistochemistry, and its correlation with clinicopathological features and prognosis was analyzed.Results·Through the TIMER2.0 database, it was found that GGPS1 expression was increased in most tumors and was highly expressed in LUSC. The expression of GGPS1 in LUSC was higher than that in adjacent tissues in UCSC Xena and UALCAN databases (both P

Objective To evaluate the effect of ultrasonography visualization teaching in the integration course of diagnostics and ultrasonic medicine for eight-year clinical medicine program students and to provide reference for further optimization of the teaching program. Methods The study conducted a questionnaire survey with electronic questionnaire in the eight-year clinical medicine program students from Peking Union Medical College who participated in ultrasonography visualization teaching of neck and abdomen. We adopted self-control study(data from the questionnaires completed by the same student before and after the course) to compare the accuracy of each knowledge point before and after teaching to evaluate the teaching effect, and collected course satisfaction ratings and feedback from the students. Results A total of 124 eight-year medical students participated in the survey, with 107 cases eight-year clinical medicine program students in grade 2017, and 17 cases '4+4' pilot class students in grade 2019 from Peking Union Medical College. Altogether 116 valid questionnaires (the response rate was 93.5%, 116/124) were collected for neck ultrasound courses and 101 valid questionnaires (the response rate was 94.4%, 101/107) for abdominal ultrasound courses. After the teaching of neck ultrasound course, the correctness of 68.8%(11/16) and 66.7%(10/15) of the knowledge points was significantly improved for the grade of 2017 and 2019 medicine students, respectively (all P < 0.05); after the teaching of abdominal ultrasound course, the correctness of 80%(4/5) of the knowledge points was significantly improved for both the grade of 2017 and 2019 medicine students (all P < 0.05). Course satisfaction surveys showed that 99.1%(115/116)of the students were very satisfied or satisfied with the cervical ultrasound course, and 0.9%(1/116) were somewhat satisfied. As for the abdominal ultrasound course, 99.0% (100/101) of the students were very satisfied or satisfied and 1.0%(1/101) were somewhat satisfied. Twenty one medical students gave feedback on the evaluation of the course, believing that ultrasound visualization teaching improved learning initiative (52%, 11/21) and learning efficiency (43%, 9/21) and stimulated learning interest (5%, 1/21); 27 medical students made suggestions on the teaching mode, among which 'increasing teaching hours' accounted for the highest proportion (56%, 15/27), followed by 'recommending reference books' (26%, 7/27). Conclusion The ultrasonography visualization teaching improves the learning initiative and efficiency of eight-year clinical medicine program undergraduates, stimulates the learning interest, and promotes their mastery of relevant knowledge.

Background The prevalence of anti-myelin oligodendrocyte glycoprotein (MOG) -IgG associated disorders (MOGAD) is significantly higher in children than that in adults. The characteristics and associations of phenotypes and recurrence risk in children are still unclear. Objective To examine the phenotypic features and recurrence factors of MOG-IgG positivity in central nervous system inflammatory demyelinating diseases in children. Methods A follow-up study on 54 children with MOGAD diagnosed in Children's Hospital of Hebei Province from December 2017 to December 2021 was performed. Phenotypic features at each demyelinating attack, laboratory tests, imaging characteristics, MOG-IgG titers in serum/cerebrospinal fluid (CSF), efficacy, and high risk factors for recurrence were analyzed. The MOG-IgG was tested using cell-based immunofluorescence assay. All patients were followed up until March 31, 2022. Results In our study, the median age of onset was 6.0 (4.0, 8.0) years and the male to female ratio was 1∶1.07. Serum MOG-IgG titers were 1∶10-1∶320. Acute disseminated encephalomyelitis (ADEM) was the most common phenotype (44.4%, 24/54), followed by optic neuritis (ON) (25.9%, 14/54) and non-ADEM-like meninges /encephalitis (20.4%, 11/54). Ten cases (18.5%) were positive for MOG-IgG in serum and CSF, and 2 (3.7%) were positive for both NMDAR-IgG in CSF and MOG-IgG in serum. Brain MRI showed new lesions during the 76.9% (60/78) of the 78 attacks in total, and the most common locations were cortical white matter (66.7%, 40/60) and optic nerve (35.0%, 21/60). Forty patients (74.1%, 40/54) experienced one episode, the main phenotypes were ADEM (57.5%, 23/40) and non-ADEM-like meninges/encephalitis (25.0%, 10/40). Fourteen patients (25.9%, 14/54) had two or more episodes, and the initial phenotype of them was ADEM with ON (57.1%, 8/14) or ON (21.4%, 3/14). Compared with recrudescent cases, non-recrudescent cases had much lower prevalence of ON or ADEM with ON as the primary phenotype (P

Nerve injury-induced protein 1 (NINJ1) is a cell-surface adhesion molecule containing an extracellular adhesion domain and two transmembrane domains. NINJ1 is named for its original discovery in damaged nerve endings. It is expressed in a variety of tissues and cells, with high expression in epithelial and myeloid cells. NINJ1 regulates nerve regeneration by promoting Schwann cell precursors and pluripotent pericytes to differentiate into Schwann cells. In diabetes-induced peripheral nerve and vascular damage, NINJ1 not only promotes nerve repair, but also regulates penile angiogenesis via angiopoietin 1 (ANG1)/tyrosine-protein kinase receptor tie-2 (TIE2) signaling pathway. NINJ1 also participates in the maturation of vitreous vascular network, which is associated with changes in the proportion of ANG1 and ANG2 in pericytes. NINJ1 mediates inflammatory cell migration across the endothelium through its extracellular adhesion domain, and thus aggravates central nervous system inflammation. However, NINJ1 cleaved by matrix metalloproteinase 9 (MMP9) can inhibit macrophage inflammatory activation, and its mimic peptide is expected to treat atherosclerosis. In addition to regulating the inflammatory phenotypes of myeloid cells, NINJ1 actively mediates plasma membrane rupture and regulates programmed cell death, which is involved in host defense against exogenous infection. Moreover, NINJ1 is up-regulated in a variety of tumor tissues, and regulates tumor suppressor P53 activity via the P53-NINJ1 loop, which mediates tumor growth and metastasis. The current review summarizes the physiological function of NINJ1 and its key regulatory roles in pathological processes, and discusses its potential value in immunomodulation and tissue regeneration, in order to provide new ideas for the prevention and treatment of injury, inflammation and tumor-related diseases.

In criminal investigations, postmortem interval （PMI） is important information to be inferred in homicide investigations, as well as the focus and the difficulty in forensic pathology research. Because the DNA content in different tissues is relatively constant and shows changes regularly with the extension of PMI, it has become a research hotspot of PMI estimation. This paper reviews the recent progress of PMI estimation technologies including DNA-based single cell gel electrophoresis, image analysis, flow cytometry, real-time fluorescence quantitative PCR and high-throughput sequencing, hoping to provide references for forensic medicine practice and scientific research.

ObjectiveStandardizationTo explore a novel special technique intensive mode (STIM) of teaching cardiac conduction system mapping skills. This method includes theoretical lecture, in vivo operation, 5-whys methods of analyses, intensive-problem oriented trainings, and assessments.MethodsTen post-graduates majoring in cardiology who have equivalent education backgrounds and technical levels were randomly divided into two groups (n=5 per group). All participants underwent a skill training on cardiac electrophysiology mapping, with one group training under the STIM and the other group under the traditional "theory-practice-test" (TPT) mode. The effect of these two educational techniques were evaluated at the end of the training.ResultsPostgraduates in the STIM group had a more solid grasp of the anatomical position and structure of the cardiac conduction system than those in the TPT group. During in-vivo operation, the students in the STIM group reconstructed and interpreted the electroanatomical maps, voltage maps, electric excitation maps, and electric conduction maps more accurately and quickly than those in the TPT group.ConclusionThe STIM teaching mode more effectively improved the basic surgical skills of postgraduates, stimulated the students' learning initiative, and improved the quality of education. STIM is a kind of intensive teaching mode of special skills, and is worth widely implementing in the education of postgraduates majoring in cardiovascular diseases.

Ischemic-reperfusion injury (IRI) is a major pathogenic factor in acute kidney injury (AKI), which directly leads to the hypoxic injury of renal tubular epithelial cells (RTECs). Although emerging studies suggest repressor element 1–silencing transcription factor (REST) as a master regulator of gene repression under hypoxia, its role in AKI remains elusive. Here, we found that REST was upregulated in AKI patients, mice, and RTECs, which was positively associated with the degree of kidney injury, while renal tubule–specific knockout of Rest significantly alleviated AKI and its progression to chronic kidney disease (CKD). Subsequent mechanistic studies indicated that suppression of ferroptosis was responsible for REST-knockdown-induced amelioration of hypoxia-reoxygenation injury, during which process Cre-expressing adenovirus–mediated REST downregulation attenuated ferroptosis through upregulating glutamate-cysteine ligase modifier subunit (GCLM) in primary RTECs. Further, REST transcriptionally repressed GCLM expression via directly binding to its promoter region. In conclusion, our findings revealed the involvement of REST, a hypoxia regulatory factor, in AKI-to-CKD transition and identified the ferroptosis-inducing effect of REST, which may serve as a promising therapeutic target for ameliorating AKI and its progression to CKD.

The problem with discontinuation of aspirin during the perioperative period is that the patient is in a hypercoagulable state, which increases the occurrence of embolism event. However, continued use during the perioperative period may increase the risk of bleeding. This article reviews the bleeding and ischemic risks of stop use aspirin before neurosurgery, in order to guide the clinical practice.

Gene expression profiling studies have shown the pathogenetic role of oncogenic pathways in extranodal natural killer/T-cell lymphoma (ENKL). In this study, we aimed to identify the microRNAs (miRNAs) playing potential roles in ENKL, and to evaluate the genes and biological pathways associated to them. Gene expression profiles of ENKL patients were acquired from the gene expression omnibus (GEO) database. Most differentially expressed (DE)-miRNAs were identified in ENKL patients using limma package. Gene targets of the DE-miRNAs were collected from online databases (miRDB, miRWalk, miRDIP, and TargetScan), and used in Gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) analyses on Database for annotation, visualization, and integrated discovery database, and then used in protein–protein interaction (PPI) analysis on STRING database. Hub genes of the PPI network were identified in cytoHubba, and were evaluated in Biological networks gene ontology. According to the series GSE31377 and GSE43958 from GEO database, four DE-miRNAs were screened out: hsa-miR-363-3p, hsa-miR-296-5p, hsa-miR-155-5p, and hsa-miR-221-3p. Totally 164 gene targets were collected from the online databases, and used in the GO and KEGG pathway analyses and PPI network analysis. Ten hub genes of the PPI network were identified: AURKA, TP53, CDK1, CDK2, CCNB1, PLK1, CUL1, ESR1, CDC20, and PIK3CA. Those hub genes, as well as their correlative pathways, may be of diagnostic or therapeutic potential for ENKL, but further clinical evidence is still expected.

Gap junction protein, alpha 1 (GJA1), which is correlated with recurrences and unfavorable prognoses in hepatocellular carcinomas (HCCs), is one of the specific proteins expressed by activated hepatic stellate cells (HSCs).

Objective This study aims to investigate the current situation of ultrasonographic teaching and learning needs from eight-year program undergraduates in Peking Union Medical College. Methods Questionnaires of the current situation about ultrasonographic teaching and learning needs from students were collected and compared with feedbacks from students from 4+4 pilot project curriculum who received a new pattern of ultrasonographic teaching. Results The students of eight-year program showed weakness in understanding of definition and development of ultrasound discipline, basic knowledge and ultrasonographic technology. They were not satisfied with the current ultrasonographic teaching and hoped to improve the curriculum content and teaching pathway. Conclusions Based on these results, the ultrasonographic curriculum design and teaching patterns should be adjusted according to students' demands and emphasize essential and basic knowledge such as ultrasonographic manifestations of normal human anatomy and that found in common diseases.

Objective To investigate the effects of high-density lipoprotein (HDL) on collagen-induced arthritis (CIA) animal model. Methods DBA/1 mice were divided into three groups: control group, CIA group and CIA+HDL group. Mice in the CIA and CIA+HDL groups were immunized with an emulsion of Freund's complete adjuvant and bovine type Ⅱ collagen on day 0. The control group was injected with saline. On day 21, the CIA group and CIA+HDL group were injected with an emulsion of Freund's incomplete adjuvant and bovine type Ⅱ collagen to streng then the immune response. The control group was injected with saline only. The CIA+HDL group was injected with HDL(10 mg/kg) on day 40 followed by HDL injection five times every 3 days. The control group and the CIA group were injected with the same volume of saline. Changes in mouse body weight and clinical scores ofarthritis were recor- ded.The mice were sacrificed on day 75, and the serum levels of tumor necrosis factor-α, anti-collagen-Ⅱ antibody IgG2a of the mice were measured using ELISA kit. Then the tissue sections of ankle joints were stained with hematoxylin-eosin to analyze the severity of rheumatoid arthritis in mice to evaluate the efficacy of high-density lipoprotein in the treatment of rheumatoid arthritis. Results Compared with the CIA group, intravenous injection of HDL at a dose of 10 mg/kg significantly alleviated the symptoms of rheumatoid arthritis in mice. The results showed that HDL alleviated the clinical symptom of arthritis and decreased the level of serum pro-inflammatory factor TNF-α and specific antibody of IgG2α (P＜0.05). Histopathological examination showed that HDL can smoothen the ankle articular surface, significantly decrease synovial hyperplasia, inflammatory cell and bone erosion and other pathological changes. Conclusions HDL can significantly alleviated the symptoms of collagen-induced rheumatoid arthritis of mice.

In December 2019, novel coronavirus pneumonia-19 (COVID-19) was discovered in the viral pneumonia cases that occurred in Wuhan, China, and then quickly spread around the world. This report described the clinical course of two COVID-19 patients and the purpose of the study was to discuss the combination of chest CT and clinical features for diagnosis of COVID-19. The first case was a typical COVID-19 case. A 66-year-old female presented to our hospital with a 3-day history of fever. She had contact with a COVID-19 patient. Chest CT showed a typical COVID-19 appearance. She was diagnosed with COVID-19 by a positive nucleic acid test. The second case was a 50-year-old male with a 2-day history of fever. He denied having been to Wuhan. Chest CT also showed typical features of COVID-19 pneumonia. COVID-19 nucleic acid tests were repeated up to seven times and the results remained controversial. Eventually, he was diagnosed with COVID-19. Our study shows that chest CT has high sensitivity for diagnosis of COVID-19 in clinical practice, particularly when the nucleic acid test is negative. The chest CT should be considered as a diagnostic tool for the COVID-19 screening, comprehensive evaluation, and follow-up and patients would benefit from effective treatments in time.

Objective To establish multiplex system of 16 miniSTR loci, and explore its application value for the degraded materials in forensic medicine. Methods The multiplex system of 16 miniSTR loci was established using a six-dye fluorescence labeling technology and its application value in forensic medicine was assessed. Results A six-dye fluorescence labeling miniSTR amplification kit was developed, which enabled 15 autosomal STR loci, Amelogenin locus and DYS391 to be typed simultaneously. This method showed good specificity and could provide stable and accurate typing results with a sensitivity of 50 pg. This system also provided a good test result for the normal biological sample of actual cases. Conclusion The multiplex system of 16 miniSTR loci has application value for degraded and trace materials with the advantages of high sensitivity and database compatibility, which can be used for forensic casework.

Abstract Amelogenesis imperfecta (AI), characterized by a deficiency in the quantity and/or quality of dental enamel, is genetically heterogeneous and phenotypically variable. The most severe type, hypocalcified AI, is mostly caused by truncating mutations in the FAM83H gene. This study aimed to identify genetic mutations in four Chinese families with hypocalcified AI. We performed mutation analysis by sequencing the candidate FAM83H gene. Three novel mutations (c.931dupC, p.V311Rfs*13; c.1130_1131delinsAA, p.S377X; and c.1147 G > T, p.E383X) and one previously reported mutation (c.973 C > T, p.R325X) in the last exon of FAM83H gene were identified. Furthermore, constructs expressing Green fluorescent protein (GFP)-tagged wild-type and three novel mutant FAM83Hs were transfected into rat dental epithelial cells (SF2 cells). Wild-type FAM83H-GFP was localized exclusively in the cytoplasm, especially in the area surrounding the nucleus, while the mutant FAM83H-GFPs (p.V311Rfs*13, p.S377X, and p.E383X) were localized predominantly in the nucleus, with lower levels in the cytoplasm.

Pancreatic islet transplantation is a promising treatment for type 1 diabetes (T1D). Interleukin-35 (IL-35) is a recently discovered cytokine that exhibits potent immunosuppressive functions. However, the role of IL-35 in islet transplant rejection remains to be elucidated. In this study, we isolated islet cells of BALB/c mouse and purified CD4+ T cell subsets of a C57BL/6 mouse. The model for islet transplantation was established in vitro by co-culture of the islet cells and CD4+ T cells. IL-35 (20 ng/ml) was administered every other day. Following co-culture, the islet function and Treg/Th17 ratio were analyzed on days 1, 3, and 5. Furthermore, the Th17/Treg ratio was modulated (1:0-2), and the function of islet cells as well as proliferation of Th17 cells were analyzed. T cell sorting was performed using the magnetic bead sorting method; Treg and Th17 count using flow cytometry; cell proliferation detection using the carboxyfluorescein diacetate succinimidyl ester (CFSE) method, and islet function test using the sugar stimulation test. Results showed that Th17 counts increased in the co-culture system. However, after administration of IL-35, the number of Treg cells increased significantly compared to that in the control group (50.7% of total CD4+ T cells on day 5 in IL-35 group vs. 9.5% in control group) whereas the proliferation rate of Th17 cells was significantly inhibited (0.3% in IL-35 group vs. 7.2% in control group on day 5). Reducing the Th17/Treg ratio significantly improved the function of transplanted islets. Treg inhibited Th17 proliferation and IL-35 enhanced this inhibitory effect. IL-35 mitigates the function of murine transplanted islet cells via regulation of the Treg/Th17 ratio. This might serve as a potential therapeutic strategy for in-vivo islet transplant rejection and T1D.

China has launched a general practice (GP)-orientated primary care reform in 2009 to develop a more productive, coordinated, and cost-effective system to maintain and improve the health and wellbeing of one-fifth of the world population. The restructure of the health care system with a focus on primary care requires practitioners working on GP as gatekeepers for service delivery that is responsive to the needs of people. It is particularly prioritised to establish a sound education and training system to ensure that the competencies of practitioners are aligned with local health care needs. This article aims to provide a brief review of the development of GP, including exemplary model of education and training currently implemented in southern China, as well as the challenges to be addressed in the next step. There is a shortage of well-trained and qualified general practitioners in China where more than half of the licensed clinicians in primary care are educated below the undergraduate level. Although there is a stepwise increase in recognition that the capacity of GP is pivotal to the success of primary care development in China, challenges coming from resource restriction, rural and urban disparity, social attitude, and community involvement are highlighted as major bottlenecks that currently hinder the rapid development of GP in China. Supportive policy and guidelines are necessary to build up strong GP recognition and ensure adequate resources to underpin a robust primary care system to deliver affordable and effective health care services for the world’s largest population. It might share some similar experiences with other countries that are struggling to develop a GP-based primary care system.

It is unclear whether an "obesity paradox" exists in the respiratory system, especially in acute respiratory distress syndrome (ARDS) and acute lung injury (ALI). Previous studies have postulated a causal relation between obesity and ARDS/ALI but have lacked power to form a definitive conclusion.To investigate the relationships between obesity, ARDS/ALIrisk, and mortality.A systematic search current to April 2016 was performed in Pubmed, EMBASE, Medline, Cochrane databases to find relevant studies. All studies that estimate the effect of obesity in the morbidity and mortality of ARDS/ALI were included.A total of 24 studies including 9,187,248 subjects were analyzed. The combined results from 16 studies that examined the effect of obesity in morbidity of ARDS/ALI showed an89% increase in odds ratio(pooled odds ratios (OR) 1.89, 95% confidence intervals (CI) 1.45 to 2.47). In subgroup analysis, compared to normal weight, obesity was associated with an increased risk of ARDS/ALI (OR1.57, 95% CI 1.30-1.90 for obese (BMI30-39.9kg/m2); OR1.75, 95% CI 1.42-2.15 for obese(BMI≥30kg/m2); OR1.67, 95% CI 1.04-2.68 for morbid obese(BMI≥40kg/m2)). The combined results from 9 studies that examined the effect of obesity in mortality of ARDS/ALI had a pooled odds ratio(pooled OR 0.63, 95% CI 0.41 to 0.98). Inversely, obesity was significantly associated with reduced risk of ARDS/ALI mortality(OR0.88, 95% CI 0.78-1.00 for overweight(BMI≤18.5m2); OR0.74, 95% CI 0.64-0.84 for obese (BMI30-39.9kg/m2);OR0.84, 95% CI 0.75-0.94 for 60days mortality; OR0.38, 95% CI 0.22-0.66 for 90days mortality).Our data identify obesity as an important risk factor for the development of ARDS/ALI; however, ARDS/ALI outcomes are improved in this population when compared to individuals with a normal body mass index. This meta-analysis results supported ''obesity paradox" in ARDS/ALI.

Abstract Background Oct4 and Sox2 are two major transcription factors related to the stem cell self-renewal and differentiation. The aim of this study was to examine the association between Oct4 and Sox2 expression levels with both the clinicopathological characteristics and prognoses of patients with hypopharyngeal squamous cell carcinoma. Method Tumor tissue samples from 85 patients with hypopharyngeal squamous cell carcinoma were collected, and the clinical follow-up data of these patients were recorded, and expression status of Oct4 and Sox2 were examined in these tissue samples by immunohistochemistry (IHC). Results Oct4 expression was found to be an independent predictive factor for overall survival (p = 0.004) in patients with hypopharyngeal squamous cell carcinoma and was independently related to loco-regional control (p = 0.001). Although Sox2 expression status showed no significant association with overall survival (p = 0.166), disease-free survival (p = 0.680) or loco-regional control (p = 0.383), when using a subgroup analysis, the subgroup with both high Oct4 and Sox2 expression had the best prognosis (p = 0.000). Sox2 expression could be a potential prognostic predictor for patients with hypopharyngeal squamous cell carcinoma. Simultaneous analyses of Oct4 and Sox2 expression could be more effective in evaluating the prognoses of patients with hypopharyngeal squamous cell carcinoma. Conclusion Oct4 expression is an independent predictive factor for patients with hypopharyngeal squamous cell carcinoma, suggesting that Oct4 expression may be a useful indicator for predicting the prognosis of hypopharyngeal squamous cell carcinoma.

Objective To explore whether the environmental pollutant triclosan (TCS) has negative effects on the various biological characteristics of dental pulp stem cells (DPSCs), as well as the distribution and hazards of TCS in rat dental pulp tissue in vivo, which will provide a basis for the clinical application of DPSCs and the safety of TCS. Methods Tooth collection was approved by the Ethics Committee of Tianyou Hospital Affiliated to Wuhan University of Science and Technology. Human DPSCs were extracted, cultured, and identified. Up to 0.08 mmol/L of TCS was added to the in vitro culture medium of DPSCs. The proliferation ability of DPSCs was detected by CCK-8. The migration ability of DPSCs was detected via scratch assay. The differentiation ability of DPSCs was detected by inducing trilineage differentiation. The gene or protein expression levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-10 (IL-10), inducible nitric oxide synthase (iNOS), and transforming growth factor-β (TGF-β) in DPSCs were detected. The level of reactive oxygen species (ROS) generated by DPSCs was analyzed using fluorescence staining. Changes in mitochondrial membrane potential of DPSCs were detected using a fluorescent probe. The activity of PI3K/Akt/mTOR, p38, and JNK pathways of DPSCs were detected. Animal experiments were approved by the Animal Ethics Committee of Wuhan University of Science and Technology. A rat model of short-term oral exposure to 50 mg/kg/d of TCS for 2 months was established, and the TCS concentration in the liver, brain, and dental pulp tissues of rats was detected through liquid chromatography-mass spectrometry. Results TCS at 0.02 mmol/L, 0.04 mmol/L, and 0.08 mmol/L significantly inhibited the proliferation ability of human-derived DPSCs on the 5th and 7th days of contact. TCS at 0.04 mmol/L and 0.08 mmol/L significantly inhibited the migration ability and tri-lineage differentiation ability of DPSCs on the 3rd day of contact. TCS induced the gene or protein expression of proinflammatory factors including TNF-α, IL-1β, IL-6, and iNOS, induced the gene or protein expression of TGF-β, and inhibited the protein expression of anti-inflammatory factor IL-10. On day 1, TCS at 0.04 mmol/L and 0.08 mmol/L induced the production of ROS in DPSCs and reduced the mitochondrial membrane potential of DPSCs. On day 3, TCS at these levels inhibited PI3K/Akt/mTOR pathway activity and enhanced p38 pathway activity of DPSCs, without affecting the pathway activity of JNK. After short-term intragastric exposure of rats to TCS, TCS was detected in liver (430 ng/mL) and brain (41.4 ng/mL) tissues but not in the dental pulp. The TCS concentration was highest in the liver, but no obvious histopathological changes were observed. Conclusion TCS inhibits a variety of biological characteristics of DPSCs and poses a potential risk to the organism. No TCS exists in the dental pulp tissue of rats exposed to TCS for a brief period of time, and the health of the rats is not damaged.

Objective To investigate the efficacy of antibacterial photodynamic therapy (aPDT) as an adjunct to subgingival scaling and root planning in the treatment of chronic periodontitis. Methods This study followed medical ethics guidelines, and informed consent was obtained from all patients. Sixteen patients were recruited for this randomized split-mouth controlled trial. The control group underwent subgingival scaling and root planning (SRP), while the experimental group received subgingival scaling and root planing plus aPDT treatment using Perowave® with a toluidine blue O solution photosensitizer. The probing pocket depth (PD), recession, plaque index (PLI), bleeding index (BI) and proportion of positive sites of bleeding on probing (BOP) (BOP%) at all sites were examined at baseline (before treatment) and at 1, 3 and 6 months after treatment. Results Follow-up was completed for 13 patients. On the control side, 356 teeth were tested at 2 136 sites. A total of 360 teeth on the test side and 2 160 sites were included in the study. Before treatment, there was no significant difference in the baseline indicators between the two groups. After treatment, both groups showed significant improvement in clinical parameters, including PD, PLI, BI, and BOP%,compared with baseline. At 3 months, the BOP% and PLI in the experimental group were significantly lower than those in the control group (PP