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The clinical data of 14 patients with neuroendocrine tumors who received Peptide Receptor Radionuclide Therapy (PRRT) from December 2018 to May 2021 were retrospectively analyzed. Among them, 2 patients demonstrated proprogressive disease, 2 patients had partial response, and 10 patients had stable disease. Grade 1-2 myelosuppression occurred in 5 patients. and 1 patient became grade 3 myelosuppression，which recovered to grade 2 after symptomatic treatment. No grade 2 or higher treatment-related renal toxicity was observed in any of the patients. PRRT is efficacy and no significant side effects for unresectable metastatic neuroendocrine tumors.回顾性分析2018年12月至2021年5月接受肽受体放射性核素治疗（PRRT）的14例神经内分泌肿瘤患者资料，其中2例疾病进展，2例部分缓解，10例病情稳定。5例出现1~2级骨髓抑制，1例出现3级骨髓抑制，经对症治疗后恢复至2级。所有患者均未发现2级以上治疗相关性肾脏毒性。PRRT对于无法手术切除的转移性神经内分泌肿瘤有较好疗效，无明显不良反应。.

Regarding the illegal performance of "tooth beauty" and the mal-practice in aesthetic dentistry, the author proposed boycotts and solutions that were making clear of the property and forming professional guidelines, getting supports from administrations by fully communication, enhancing oral health education, promoting self-discipline within professions, and standing firmly on medical profession morals.针对社会上非医疗“美牙”行业和口腔行业内部存在的不合规“美牙”服务，本文从专业的观点出发，提出抵制和解决办法：①从根源上认清事情的本质，形成专业的意见和建议；②充分沟通，获取社会管理和监管部门的支持；③加强口腔医学健康教育；④加强行业自律，坚守医学的初心。.

OBJECTIVE: To evaluate the influence of base materials on stress distribution in endodontically treated maxillary premolars restored with endocrowns using three-dimensional finite element analysis. METHODS: A maxillary second premolar was scanned by Micro-CT and a three-dimensional finite element model of ceramic endocrown with 1 mm thickness of base was established. A model without base was also established as a negative control. Four kinds of conventional base materials with different elastic modulus were adopted: light cure glass ionomer(3M Vitrebond, 3 657 MPa), flowable composite resin(3M Filtek Z350XT Flowable Restorative, 7 300 MPa), high strength glass ionomer(GC Fuji Ⅸ, 13 130 MPa), and posterior composite resin(3M Filtek P60, 19 700 MPa). With a 200 N force loaded vertically and obliquely, the distribution and magnitude of stress in the tooth tissue and adhesive layer were investigated by three-dimensional finite element analysis. RESULTS: The maximum von Mises stress values(vertical/oblique) in dentin and adhesive layer were measured as follows: (1) no base material: 19.39/70.49 MPa in dentin and 6.97/17.97 MPa in adhesive layer; (2) light cure glass ionomer: 19.00/69.75 MPa in dentin and 6.87/16.30 MPa in adhesive layer; (3) flowable composite resin: 18.78/69.33 MPa in dentin and 6.79/16.17 MPa in adhesive layer; (4) high strength glass ionomer: 18.71/69.20 MPa in dentin and 6.74/16.07 MPa in adhesive layer; (5) posterior composite resin: 18.61/69.03 MPa in dentin and 6.70/16.01 MPa in adhesive layer. Under the same loading condition, models with different elastic moduli of base materials had similar stress distribution patterns. The von Mises stress of tooth tissue was mainly concentrated in the tooth cervix. Under oblique load, the regions where von Mises stress concentrated in were similar to those under a vertical load, but the values increased. The stress concentration in the tooth cervix was alleviated in models with base materials compared with the model without base material. The maximum von Mises stress in the tooth tissue and adhesive layer decreased when the elastic modulus of base materials increased and got close to that of dentin. CONCLUSION: The posterior composite resin of which the elastic moduli is high and close to that of dentin is recommended as base material for premolar endocrowns to alleviate the concentration of stress in tooth cervix and adhesive layer.

Epigenetics refers to genetic regulation patterns that gene expressions, which lead to the phenotype variance, are modified in the absence of changes of DNA sequence. Epigenetics mainly includes DNA methylation, histone modification, and non-coding RNA regulation. During the development of the teeth, conventional gene regulation and epigenetics synergistically regulate the spatial and temporal expression of genes, which involved in cell proliferation, differentiation and finally the formation of teeth. Exploration of the epigenetic regulation mechanisms during tooth development can provide multiple clues and ideas for the research of tooth regeneration. This article reviewed the significant roles of epigenetic regulation in tooth development.表观遗传是指DNA序列不发生变化，基因的表达方式发生了可遗传改变的一种遗传方式，主要包括DNA甲基化、组蛋白修饰和非编码RNA调控等。在牙发育过程中，传统基因调控与表观遗传学调控共同参与协同，调节细胞增殖分化相关基因的时空表达。探索牙发育过程中的表观遗传调控机制，可为牙再生提供线索和思路，本文主要对表观遗传调控在牙发育中的作用进行综述。.

OBJECTIVE: To observe the wear performance of Giomer and universal composite for posterior restorations by 3D laser scan method, in order to guide the material selection in clinic. METHODS: In this study, 48 patients (108 teeth) were selected according to the inclusion and exclusion criteria. All the patients in need of a minimum of 2 Class Ⅰ and/or Class Ⅱ restorations were invited to join the study. The teeth were restored with Giomer (Beautifil Ⅱ, BF) and universal composite (Filtek Z350, Z350) randomly. The restorations were evaluated at baseline and after 6-, 18-, 48-month using the modified United States Public Health Service (USPHS) criteria for clinical performance. The in vivo images and gypsum replicas were taken at each recall. A 3D-laser scanner and Geomagic Studio 12 were used to analyze the wear depth quantitatively. Statistical analysis was performed with SPSS 20.0. RESULTS: After 4 years, 89.6% patients were recalled. The survival rate of both materials was 95.8% (Kaplan-Meier survival analysis). Seven restorations of the two materials failed due to loss of restoration, bulk fracture, secondary caries and pulp necrosis. The wear patterns of restorations were divided into 2 classes. Pattern Ⅰ: occlusal contact areas showed the deepest and fastest wear depth; pattern Ⅱ: the wear depth was slow and uniform. Both materials showed a rapid wear in the first 6 months. Then the wear rate was decreased. The occlusal wear depth after 4 years were (58±22) μm and (54±16) μm for BF group and Z350 group respectively, which were in accordance with the American Dental Association (ADA) guidelines (wear depth for 3 years < 100 μm). No significant differences (P>0.05) were observed between the two groups. Regarding the restorations with wear pattern Ⅰ, the wear depth of BF group was higher than Z350 group at 6- and 48-month (P < 0.05), while there was no significant difference between restorations with wear pattern Ⅱ (P>0.05). CONCLUSION: Within the limitation of the study, after 4 years, the survival rate and wear resistance of Giomer met ADA guidelines for tooth-colored restorative materials for posterior teeth. When the two materials were applied in occlusal contact areas, wear resistance of Giomer was slightly lower than universal composite resin. No significant difference was found when they were applied in none of the occlusal contact areas.

The purpose of this study was to detect the expression levels of plasma microRNA-21 (miRNA-21) and NT-proBNP (N-terminal prohormone of brain natriuretic peptide) in children with Kawasaki disease (KD), as well as their clinical significance.Children with KD (n=100) who were treated in our hospital from June 2017 to May 2019 were included. In the same period, non-KD children with febrile diseases were included as controls. Plasma levels of miRNA-21 and NT-proBNP were detected by reverse transcriptase-polymerase chain reaction (RT-PCR) and electrochemiluminescence, respectively. Then, the relationship between miRNA-21 and NT-proBNP in children with KD was analyzed by Pearson's correlation test. Potential factors influencing KD were analyzed by Multivariate logistic regression test. Finally, receiver operating characteristic (ROC) curves were depicted to assess the diagnostic potentials of miRNA-21 and NT-proBNP in KD.The results showed that miRNA-21 and NT-proBNP levels were higher in children with KD. Plasma level of miRNA-21 was positively correlated with NT-proBNP level in children with KD. Besides, both miRNA-21 and NT-proBNP were risk factors influencing the onset of KD. According to ROC curves, the sensitivity and specificity of miRNA-21 in diagnosing KD was 83% and 89%, respectively (AUC=0.9212, 95% CI: 0.8809-0.9614, cut-off value=1.985). NT-proBNP also displayed diagnostic potential in KD (AUC=0.9788, 95% CI: 0.9630-0.9946, cut-off value=265.6, sensitivity=88%, specificity=95%).MiRNA-21 and NT-proBNP are upregulated in plasma of children with KD. They are positively correlated with each other and serve as risk factors for KD. Both of them can be utilized as indicators of auxiliary diagnosis in KD.

Destruction of extracellular matrix (ECM), especially collagen II and aggrecan, is an essential feature of intervertebral disc degeneration (IDD). This project planned to elucidate the role of cartilage-derived morphogenetic protein-1 (CDMP-1) in the collagen II and aggrecan synthesis of nucleus pulposus (NP) cells under the IL-1β induced degeneration.We cultured human primary NP cells in the different concentrations of IL-1β medium and analyzed the CDMP-1 level. Recombinant human CDMP-1 protein was used to co-culture with IL-1β to investigate its effects on collagen II and aggrecan synthesis of NP cells. Additionally, the bone morphogenetic protein type IB receptor (ALK6) gene silenced and upregulated NP cells were used to evaluate the function of ALK6 in the CDMP-1 treated NP cells. Collagen II, aggrecan, MMP9, MMP13, and TIMP4 expression level were analyzed to assess the ECM stability of NP cells.CDMP-1 gene expression decreased in the IL-1β treated NP cells with a dose-dependent. Appropriate CDMP-1 protein supplement contributed to the collagen II and aggrecan production, the suppression of MMP9 and MMP13, and the upregulation of TIMP4. However, the silencing of ALK6 rejected the positive function of CDMP-1 on the collagen II and aggrecan; on the contrary, ALK6 upregulation magnified the CDMP-1 induced collagen II and aggrecan production.CDMP-1 is efficient in promoting the collagen II and aggrecan synthesis of NP cells, which is probably based on the mediation of ALK6.

OBJECTIVE: To evaluate the microtensile bond strength of resin composite to glass ceramic, and the effect of surface treatment of resin composite and thermal cycling aging on the microtensile bond strength. METHODS: Rectangular blocks were made with dentin of extracted molars, resin composite or feldspathic glass ceramic respectively. The bonding surfaces of these rectangular blocks were sanded by 600-grit silicon carbide paper before luting. A self-etching resin cement was used as luting agent. The specimens were divided into groups according to the types of substrates of adhesion (dentin/glass ceramic or resin composite/glass ceramic), the way of surface treatments and whether thermal cycling aging ocurred. The dentin blocks were adhered to ceramic blocks as controls (group A1 and A2). The resin composite blocks were adhered to the ceramic blocks as experiment groups. The resin composite surfaces were treated by different ways before luting: no extra surface treatment (group B1 and B2), treated by ethyl methacrylate solution (group C1 and C2) or silane coupling agent (group D1 and D2), coarsened by 360-grit silicon carbide paper (group E1 and E2) or polished by 1 200-grit silicon carbide paper (group F1 and F2). After luting, the microtensile bond strength of the specimens were tested before (group A1-F1) or after (group A2-F2) thermal cycling aging. After microtensile bond strength test, the fracture bonding surfaces of the specimens were observed by a scanning electron microscopy to determine the type of bonding failure. The data were statistically analyzed using one-way analysis of variance. RESULTS: The microtensile bond strength of resin composite to glass ceramic with no extra treatment achieved high bond values before and after thermal cycling [B1 (30.02±3.85) MPa, B2 (26.83±3.14) MPa], which were statistically different from those of the control groups [A1 (20.55±4.51) MPa, A2 (12.94±0.69) MPa, P < 0.05]. The microtensile bond strength between the glass ceramic and resin composite did not increase after different surface treatments of resin composite. CONCLUSIONS: The microtensile bond strength between resin composite and glass ceramic achieved as similar bond strength as that between dentin and glass ceramic and even better. Surface treatment of resin composite via methyl methacrylate solution, silane coupling agent, coarsening, or polishing did not increase the microtensile bond strength effectually.

The emergence of antibiotics residues in pharmaceutical industrial wastewater has been a significant environment problem. However, current methods of treating antibiotic-polluted wastewater are inefficient, of high cost and time-consuming. In this study, highly effective enzymatic Fe3O4 magnetic nanoparticles were developed, which is extremely simple and can degrade antibiotics in a fast manner at a low cost. β-Lactamase, a representative enzyme for β-lactam antibiotic degradation, was covalently immobilized on the surface of magnetic nanoparticles modified with amino groups by a simple cross-linking process. The immobilized β-lactamase displayed a wider pH and temperature range for penicillin G degradation than the free enzyme. Meanwhile, the thermostability and storage stability of the immobilized β-lactamase were improved. Fifty milligrams magnetic nanoparticles immobilized with β-lactamase can thoroughly degrade 100 mL penicillin G (5–50 mg L−1) within 5 min. Even if the β-lactamase immobilized on the nanoparticles was reused 35 times in the 5 mg L−1 penicillin G solution, it still kept more than 95% degradation efficiency. These suggest that magnetic nanoparticles immobilized with β-lactamase have a sufficient capacity for degrading antibiotics in wastewater and will serve as a practical and economical solution to antibiotic pollution in pharmaceutical industrial wastewater treatment.

Background Contrast-induced acute kidney injury (CI-AKI) is one of the most serious complications in patients who undergo percutaneous coronary intervention (PCI), especially in those with acute coronary syndrome. It has been shown that inflammation may play an important role in the pathophysiology of CI-AKI. Hypothesis Inflammatory factors may play a predominant role in the prediction of CI-AKI in patients who undergo emergency PCI. Methods Patients who underwent emergency PCI from 2013 to 2015 were consecutively enrolled and were divided into CI-AKI and non–CI-AKI groups. Logistic analysis was used to identify the risk factors of CI-AKI. Receiver operator characteristic curve analysis was performed to evaluate the area under the curve (AUC) and to establish the optimal cutoff. Results A total of 1061 patients were included, and the CI-AKI rate was 5.47% (58/1061). Logistic analysis showed that the white blood cell (WBC) count (odds ratio [OR]: 1.103, 95% confidence interval [CI]: 1.018-1.195, P = 0.016), neutrophil (N) count (OR: 1.134, 95% CI: 1.045-1.232, P = 0.003), neutrophil to lymphocyte ratio (NLR) (OR: 1.105, 95% CI: 1.044-1.169, P = 0.001), C-reactive protein (CRP) level (OR: 1.006, 95% CI: 1.001-1.011, P = 0.020), high-sensitivity C-reactive protein (hs-CRP) level (OR: 1.099, 95% CI: 1.020-1.184, P = 0.013), and big endothelin-1 (ET-1) level (OR: 4.030, 95% CI: 1.989-8.165, P < 0.001) were all significant predictors for CI-AKI, as was the left ventricular ejection fraction and diuretic administration. The AUC of the big ET-1 level was the highest (0.793, 95% CI: 0.733-0.853), followed by the NLR (0.708, 95% CI: 0.641-0.774), hs-CRP level (0.705, 95% CI: 0.627-0.782), CRP level (0.684, 95% CI: 0.607-0.761), N count (0.655, 95% CI: 0.584-0.726), WBC count (0.620, 95% CI: 0.544-0.695), and erythrocyte sedimentation rate (0.611, 95% CI: 0.527-0.695). Conclusions The WBC count, N count, NLR, CRP level, hs-CRP level, and big ET-1 level are all associated with an increased risk of CI-AKI, and among which, the big ET-1 level, NLR, and the hs-CRP level might have high predictive value for CI-AKI after an emergency PCI.

People are generally more aware of infectious diseases, cardiovascular diseases, trauma and other fatal diseases rather than oral diseases. In fact, the oral disease as a whole is ranked the third among the chronic diseases of human beings. There have been accumulating evidences that oral health plays a significant role in general health and quality of life. There is a wide recognition that oral health shares common risky/pathogenic factors with other Non-Communicable Diseases (NCD). Oral microorganisms may cause dental caries and periodontal diseases, and they may also cause atherosclerosis and heart diseases, thus these usually end up to chronic diseases. On the other hand, unhealthy diet, physical inactivity, tobacco and alcohol consumption, psychological stress, poor sanitation, accidents and a sedentary lifestyle contribute to both oral diseases and a number of general chronic diseases. Oral health cannot be dealt with in isolation from other health issues. That is why the WHO recommended the "Common Risk Factor Approach (CRFA)" for oral health promotion. In this article, the authors give essential interpretation of CRFA and make suggestions on preventing and controlling oral diseases via CRFA.相对于传染病、心血管疾病、外伤等致命性疾病，社会对口腔疾病的防控关注度明显不足。而事实上，科学研究表明，口腔疾病对社会所造成的疾病负担在过去几十年里一直位居所有慢性病的前列。研究还表明，口腔疾病与全身疾病关系密切，存在共同的致病因子，如口腔里的微生物可以导致龋病和牙周病，也可以引起动脉粥样硬化和心血管疾病；同时，一些不良的生活方式，如过多糖的消耗、吸烟、饮酒、外伤、心理压力、卫生条件差和缺乏运动是口腔疾病和糖尿病、心血管疾病、癌症等慢性病的共同危险因素。鉴于此，世界卫生组织提出"共同危险因素策略"作为口腔疾病的防控策略之一。本文对共同危险因素策略进行解读，提出以共同危险因素策略为指导、适当调整我国口腔疾病的防控策略，并对口腔健康教育内容以及实施方式提出建议，以期引起社会各界及口腔同行对当前的口腔疾病防控策略有更多的关注与思考。.

Background Although primary percutaneous coronary intervention (pPCI) is the optimal reperfusion method for ST-segment elevation myocardial infarction (STEMI), it remains difficult to implement in many areas. Some STEMI patients have to accept fibrinolytic therapy and no reperfusion therapy instead. Purpose The aim of this study was to describe the impact of reperfusion therapy on the long-term outcomes of STEMI patients in China. Methods Using data from the China Acute Myocardial Infarction (CAMI) registry, we analyzed the 2-year outcomes of 18,075 STEMI patients symptom onset within 7 days from January 2013 to September 2014 according to the type of reperfusion therapy. The primary endpoint was a composite of major adverse cardiovascular event (MACE), defined as all-cause mortality, myocardial infarction or stroke. Results 7798 (43%) were treated with pPCI and 1798 (10%) underwent fibrinolysis; 8479 (47%) did not receive any reperfusion. The 2-year MACE was 9.6% following pPCI, 15.7% following fibrinolysis, and 21.5% for patients without reperfusion therapy (P6 hours (HR 0.86, 95% CI 0.76–0.97, P=0.01) of symptom onset. Adjusted cumulative MACE rate Conclusions In a real-world setting, early reperfusion is the optimal strategy for STEMI. Fibrinolysis was not associated with better outcome in STEMI patients admitted >3 hours of symptom onset in Chinese real world setting. Acknowledgement/Funding Ministry of Science and Technology of China (Grant No. 2011BAI11B02)

Background Prediction of in-hospital bleeding is critical for clinical decision making for acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI). Machine learning methods can automatically select the combination of the important features and learn their underlying relationship with the outcome. Objective We aim to evaluate the predictive value of machine learning methods to predict in-hospital bleeding for AMI patients. Methods We used data from the multicenter China Acute Myocardial Infarction (CAMI) registry. We randomly partitioned the cohort into derivation set (75%) and validation set (25%). Using data from the derivation set, we applied a state-of-art machine learning algorithm, XGBoost, to automatically select features from 106 candidate variables and train a risk prediction model to predict in-hospital bleeding (BARC 3, 5 definition). Results 16736 AMI patients who underwent PCI were consecutively included in the analysis, while 70 (0.42%) patients had in-hospital bleeding followed the BARC 3,5 definition of bleeding. Fifty-nine features were automatically selected from the candidate features and were used to construct the prediction model. The area under the curve (AUC) of the XGBoost model was 0.816 (95% CI: 0.745–0.887) on the validation set, while AUC of the CRUSADE risk score was 0.723 (95% CI: 0.619–0.828). Relative contribution of the 12 most important features Feature Relative Importance Direct bilirubin 0.078 Heart rate 0.077 CKMB 0.076 Creatinine 0.064 GPT 0.052 Age 0.048 SBP 0.036 TG 0.035 Glucose 0.035 HCT 0.031 Total bilirubin 0.030 Neutrophil 0.030 ROC of the XGBoost model and CRUSADE Conclusion The XGBoost model derived from the CAMI cohort accurately predicts in-hospital bleeding among Chinese AMI patients undergoing PCI. Acknowledgement/Funding the CAMS innovation Fund for Medical Sciences (CIFMS) (2016-12M-1-009); the Twelfth Five-year Planning Project of China (2011BAI11B02)

Aims We aim to investigate the effect of single dose of statin pretreatment prior to primary Percutaneous Coronary Intervention (PCI) on long-term clinical outcomes in patients with ST-elevation Myocardial Infarction (STEMI). Methods Using data from China Acute myocardial Infarction (CAMI) registry, we compared the outcome in STEMI patients with vs without atorvastation pretreatment prior to primary PCI. The primary endpoint was the composite outcome of all-cause mortality, non-fatal MI or stroke events during follow-up. Propensity-score (PS) matching was used to assemble a cohort of patients with similar baseline characteristics. All patients were followed till 24 months since baseline. Results Of all 3772 patients who met our inclusion criteria at 108 hospitals in China, 3288 patients (1644 patients in each arm) were included in our PS-matched cohort. In the PS-match cohort, overall 144 (8.65%) and 113 (6.79%) patients in the control group and pretreatment group had the primary endpoint respectively (p=0.048). The estimated HRs were 0.78 (95% CI: 0.606–0.997, p=0.046) in the unadjusted model and 0.76 (95% CI: 0.596–0.984, p=0.032) in the adjusted model (Figure). The HRs were broadly similar for the pretreatment dosage of 40 mg or 80 mg (0.78 vs 0.77, p=0.75). The HRs were even stronger in patients with single-vessel only than multi-vessel coronary artery disease (0.31 vs 0.75, p=0.014). Conclusion Among Chinese patients with STEMI, atorvastatin pretreatment before primary PCI may have better long-term composite outcome of all-cause mortality, non-fatal MI, or stroke events. Acknowledgement/Funding CAMS Innovation Fund for Medical Sciences (CIFMS) (2016-I2M-1-009)

Traumatic arthritis is one of the most common diseases in orthopedics. LGR4 is involved in bone formation and bone development. However, the role of LGR4 in synovial cells of rats with traumatic osteoarthritis has not been reported.Sprague Dawley (SD) rats were randomly divided into the control group and model group. The Real Time-Polymerase Chain Reaction (RT-PCR), Western blot, and Enzyme-Linked Immunosorbent Assay (ELISA) were used to analyze the expression of LGR4 in synovial tissue and synovial fluid. Synovial cells were isolated and cultured, followed by transfection of LGR4-pcDNA3.1 plasmid into cells. Cell proliferation was analyzed by MTT and EdU assay, and the Caspase-3 activity was assessed using the Caspase-3 activity kit. The secretion of the inflammatory factors interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) was detected by ELISA. NF-κB signaling pathway changes were evaluated by the Western blot.In the model group, LGR4 mRNA expression in synovial tissue was significantly decreased, and the secretion of LGR4 in the synovial fluid was significantly decreased compared with the control group (p0.05). LGR4 protein expression in the synovial membrane in the model group tissue was reduced. The transfection of LGR4-pcDNA3.1 plasmid into synovial cells promoted the LGR4 expression, inhibited the proliferation of synoviocytes, increased the Caspase-3 activity, the secretion of IL-1, TNF-α, and IL-6, as well as the decreased expression of NF-κB with a statistical significance, compared with the control group (p0.05).LGR4 expression is reduced in the rat model of traumatic osteoarthritis. The upregulation of LGR4 expression can inhibit the secretion of the inflammatory factors and inhibit the proliferation of the synovial cells by regulating NF-κB signaling pathway, which may alleviate the development of the joint inflammation.

Animal and imaging study evidence favors early reperfusion for acute myocardial infarction. However, in clinical trials, the effect of symptom-onset-to-balloon (S2B) time on clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) has been inconsistent. Moreover, there are few data regarding the ischemic time in China. A total of 3,877 consecutive patients with STEMI with available S2B time undergoing pPCI from January 2013 to September 2014 at 108 hospitals that participated in the China Acute Myocardial Infarction registry were included and stratified into 3 S2B groups:6 hours, 6 to 12 hours,12 hours S2B time was tested in multivariate logistic regression analyses as an independent risk factor of mortality (primary outcome), major adverse cardiovascular and cerebrovascular events (MACCE), and impaired myocardial perfusion (secondary outcomes). The median S2B time was 5.5 (3.75 to 8.50) hours. Longer S2B time was associated with higher in-hospital mortality (6 hours: 2.7%; 6 to 12 hours: 3.4%;12 hours: 4.9%; p = 0.047) and ST-segment resolution50% (6 hours: 16.7%; 6 to 12 hours: 19.2%;12 hours: 24.3%; p = 0.002) but not MACCE. In multivariate-adjusted analysis, S2B12 hours remained associated with ST-segment resolution50% (odds ratio 1.53, 95% confidence interval 1.16 to 2.01, p = 0.002) but not with in-hospital mortality (odds ratio 1.673, 95% confidence interval 0.95 to 2.94, p = 0.073). In conclusion, median S2B time in patients with STEMI undergoing pPCI was longer than that in registry studies from other countries. Longer S2B time was associated with impaired myocardial perfusion but not with in-hospital mortality or MACCE.

Boron carbide (B4C) doped with graphene nano-platelet (GNP) as reinforcement has been prepared by pressureless sintering. Effect of GNP addition on mechanical properties of the composite, such as fracture toughness, hardness, flexural strength was investigated. Phase evolution and microstructure was characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM). Results demonstrated that addition of GNP improved the fracture toughness (KIC) of B4C with the decrease of hardness, flexural strength. The fracture toughness (KIC) can reach 4.45 MPam1/2 with 1wt% addition of GNP, which was 49.3% higher than that of the composite without graphene platelets. It was found that the toughening mechanism can be contributed to pulling-out of graphene platelets, crack deflection, bridging and branching.

To further improve the comprehensive performance of existing impact-resistant steel, rare-earth-modified steel samples were experimentally prepared and their performance was analyzed. Different amounts of mixed rare earths were added into the 30MnCrNiMo impact-resistant steel, followed by vacuum smelting, forging, and rolling to prepare the steel plate. The effects of rare earths on the phase transformation critical points, high-temperature deformation behavior, microstructure, and mechanical properties were studied. The results show that rare earths can play a purifying role in the test steel. The Ac1-Ac3 phase transition temperatures were increased, and those of the Bs-Bf phase transition were decreased significantly. When compressed at 1000 °C, the deformation resistance of the test steel with rare earth became higher. Thus, the added rare earths improve the microstructural morphology and inclusions in the steel, as well as the comprehensive mechanical properties.

Hexagonal boron nitride ceramic (h-BN) based on the nitridation of B powders was obtained by reaction sintering method. The dynamic compressive response was investigated using a Split Hopkinson pressure bar tester at high strain rates in a range of 0.8×103−1.6×103s−1. By increasing the strain rate, the dynamic strength and the failure strain increased continuously. The compressive stress–strain curves exhibited universal three deformation regions, including inelastic deformation region, rapid loading region and failure region. The failure mode of the h-BN ceramic depended upon the strain rate.

ObjectiveTo investigate the morphology and dimensions of the vestibular aqueduct on axial, single-oblique and double-oblique computed tomography images.MethodsThe computed tomography temporal bone scans of 112 patients were retrospectively evaluated. Midpoint and opercular measurements were performed using axial, single-oblique and double-oblique images. Morphometric analyses were also conducted. The vestibular aqueduct sizes on axial, single-oblique and double-oblique images were compared.ResultsAt the midpoint, the mean (± standard deviation) vestibular aqueduct measured 0.61 ± 0.23 mm, 0.74 ± 0.27 mm and 0.82 ± 0.38 mm on axial, single-oblique and double-oblique images, respectively; at the operculum, the vestibular aqueduct measured 0.91 ± 0.30 mm, 1.11 ± 0.45 mm and 1.66 ± 1.07 mm on the respective images. The co-efficients of variation of the vestibular aqueduct measured at the midpoint were 37.4 per cent, 36.5 per cent and 47.5 per cent on axial, single-oblique and double-oblique images, respectively; at the operculum, the measurements were 33.0 per cent, 40.5 per cent and 64.5 per cent. Regarding morphology, the vestibular aqueduct was fissured (33.5 per cent), tubular (64.3 per cent) or invisible (2.2 per cent).ConclusionThe morphology and dimensions of the vestibular aqueduct were highly variable among axial, single-oblique and double-oblique images.

To evaluate the accuracy of optical coherence tomography (OCT) in detecting root cracks after root canal instrumentation using histological gold standard.Twenty complete extracted human mandibular incisors that were free of caries, calculus, and root treatment were chosen and accessed coronally with a diamond bur, then mounted in resin blocks with alginate impression material using simulated periodontal ligaments, and the apex was exposed 3 mm. The teeth were stored in water at room temperature. Then the teeth were then instrumented to the major apical foramen (AF) at #30/0.09 using ProTaper Universal rotary nickel titanium system (Dentsply Maillefer, Ballaigues, Switzerland), irrigation with 1% sodium hypochlorite (NaOCl) by using a 26-gauge needle followed after each instrument. The apical root was scanned with 360° of rotation by Swept-Source Optical Coherence Tomography (SS-OCT) (wavelength: 1 310 nm, scan rate: 20 kHz, axial resolution: 16 μm) with driving device (stepper motor and lifting platform). The reconstruction images of axial planes 1, 2 and 3 mm from the apex were examined and the root cracks were blindly diagnosed by two observers. The horizontal section was performed at 1, 2 and 3 mm from the apex using low speed disc saw (Leica SP1600, Wetzlar, Germany). The presence of cracks was noted under an optical stereomicroscope (ZOOM-630E) with a cold light source using as gold standard to evaluate the accuracy of OCT in detecting root cracks after root canal instrumentation.After canals instrumentation with ProTaper Universal rotary nickel titanium system to #30/0.09, root cracks were detected in 9 of 20 teeth by histological examination. Crack lines were observed on 13 of 60 horizontal sections and cracks on 12 of the 13 sections were detected by OCT. No cracks were observed in the other 47 of the 60 horizontal sections,none of which was misdiagnosed by OCT. The overall accuracy rate for detection of root cracks with OCT was 0.983, the sensitivity was 0.923, the specificity was 1.000, the positive predictive value (PPV) was 1.000 and the negative predictive value (NPV) was 0.979.OCT may be a promising nondestructive imaging method for diagnosing root canal cracks after canal instrumentation.

Summary Increasing evidence indicates that aberrant neutrophil extracellular trap (NET) formation could contribute to the pathogenesis of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Recent research has provided evidence that a novel type of ANCA autoantibody, anti-lysosomal membrane protein-2 (LAMP-2) antibody, may have a pathogenic role in AAV. We have shown previously that anti-LAMP-2 antibody-stimulated NET formation contains autoantigens and anti-microbial peptides. The current study sought to determine whether LAMP-2, as a novel antigen of ANCA, was present on NETs in AAV patients, the influence of the anti-LAMP-2 antibody on the neutrophil apoptosis rate and the role of autophagy in anti-LAMP-2 antibody-induced NET formation. NET formation was assessed using immunofluorescence microscopy, scanning electron microscopy or live cell imaging. The neutrophil apoptosis rate was analysed using fluorescence activated cell sorting (FACS). Autophagy was detected using LC3B accumulation and transmission electron microscopy. The results showed that enhanced NET formation, which contains LAMP-2, was observed in kidney biopsies and neutrophils from AAV patients. The apoptosis rate decreased significantly in human neutrophils stimulated with anti-LAMP-2 antibody, and this effect was attenuated by the inhibitors of autophagy 3-methyladenine (3MA) and 2-morpholin-4-yl-8-phenylchromen-4-one (LY294002). The anti-LAMP-2 antibody-stimulated NET formation was unaffected by benzyloxycarbonyl-Val- Ala-Asp (OMe)-fluoromethylketone (zVAD-fmk) and necrostatin-1 (Nec-1), which are inhibitors of apoptosis and necrosis, respectively, but was inhibited by 3MA and LY294002. Moreover, the proportion of LC3BI that was converted to LC3BII increased significantly (P = 0·0057), and massive vacuolizations that exhibited characteristics typical of autophagy were detected in neutrophils stimulated with anti-LAMP-2 antibody. Our results provide further evidence that autophagy is involved in ANCA-induced NET formation in human neutrophils.

To compare the osteogenic effects of a nano-sized 58S bioactive glass (nano-58S BG) and a traditional 45S5 bioactive glass(45S5 BG) in penetrating parietal critical bone defects.Critical bone defect with 9 mm diameter was created in the parietal bone of New Zealand rabbits. The bone defects were then filled with either nano-58S BG, or 45S5 BG, or nothing but the newly-formed blood clot as the blank control at random. For histological observation, specimens were gained 4 and 8 weeks after the surgery, sectioned and stained by HE. The amount of collagen type I was observed with Picric-Sirius Red staining through polarimetry. To observe the new bone formation with fluorescence under the laser confocal microscope, we injected fluorescent markers 14, 28, and 42 days after the surgery. The markers were tetracycline hydrochloride, alizarin red and calcin individually in chronological order. Image J software was used to quantify the bone regeneration.HE staining showed that BG particulates were integrated with the surrounding tissue without any inflammatory cells infiltration 4 weeks after surgery. New bone regeneration was observed both from the border and in the center of the defects in both BG groups. No bone regeneration in defect center was observed in control group. At the end of 8 weeks, there was more bone regeneration in nano-58S group compared with 45S5 group and control group. The structure of the new bone in BG groups was hollow, which was similar to the natural normal parietal bone. No hollow structure was observed in the new bone of control group. Picric-sirius Red polarimetry showed that more amount of collagen type I was found in nano-58S group than in either 45S5 or control group. The fluorescent observation of the hard tissue slices at the end of 8 weeks showed statistically larger scope and faster new bone formation in nano-58S group with (29.4±4.48) μm thickness from 4-6 weeks and (35.3±3.74) μm from 6-8 weeks compared with 45S5 group [(13.43±3.44) μm and (17.64±4.13) μm] and control group [(5.88±2.92) μm and (6.07±3.02) μm, P0.01].Compared with the traditional 45S5 bioactive glass, 58S nano-sized bioactive glass showed better osteogenic effect in bone regeneration in parietal bones of rabbits.

Профили транскриптомов клеточных линий рака молочной железы человека MCF-7 и MDA-MB-435 исследовали с использованием технологии высокопроизводительного секвенирования RNA-Seq. Для скрининга дифференциально экспрессирующихся транскриптов использован пакет программ DESeq. Всего выявлено 229 генов со значимо различающейся экспрессией в клетках MDA-MB-435 по сравнению с клетками MCF-7. Аннотирование биологических функций через Базу данных для аннотации, визуализации и интегрированного обнаружения (DAVID v6.7) позволило выявить, что эти 229 дифференциально экспрессирующихся генов главным образом вовлечены в биологические функции, связанные с клеточной адгезией и движением, процессингом и презентацией антигенов (через MHC класса II), гормональным ответом, организацией внеклеточных структур, ремоделированием тканей и регулированием пролиферации клеток. При анализе индивидуальных генов выявлено, что по сравнению с MCF-7 у клеток MDA-MB-435 выше способность к метастазированию, а также к процессингу и презентации антигенов, и снижена способность к гормональному ответу. Двадцать наиболее представленных транскриптов в клетках MDA-MB-435, такие как VIM, TNC и CD74, ассоциируются с высоким метастатическим потенциалом. Помимо генов, которые, как ранее сообщалось, вовлечены в метастазирование и развитие опухолей, вновь идентифицированные в этом исследовании гены могут послужить основой для выработки нового подхода в вопросах диагностики и прогнозирования агрессивного рака молочной железы.

The general principles and key points in writing of a scientific article in stomatology were interpreted based on the national guideline and the author's personal experiences in the present article. Efforts should be made by the authors focusing on core information, refinement and description of their papers. In the second half of the article, the general process of paper review was introduced. The article also gave suggestions on how to response to the reviewers' questions. It is well recognized that a good scientific journal was created by good authors, good reviewers and good editors. The author proposed that efforts by above mentioned three parties should be gathered to make more valuable, delicately designed and well performed clinical research articles be published.学习国家标准，结合本文作者自身撰稿、审稿的体会，本文概要介绍了口腔医学科技论文撰写过程中应该遵守的原则和撰写要点。强调对论文中关键信息的提炼与表述。同时，介绍了科技期刊的一般审稿流程并对作者如何应对审稿专家的意见提出实用性建议。本文作者认为，著名的杂志是由好的著者、好的审稿专家和好的编辑者合力形成，建议重视临床科学问题的提炼和发现，共同努力，争取更多有价值的优秀临床科研论文得以发表。.

This study investigated the effects of immune complexes (ICs) on tumor necrosis factor α (TNF-α) and B cell-activating factor (BAFF) production from U937 cells and further explored the mechanism.U937 cells were incubated with necrosis supernatant or systemic lupus erythematosus (SLE) sera alone, or their combination. The expression of TNF-α and BAFF was determined by Real-time polymerase chain reaction and enzyme-linked immunosorbent assay. High mobility group box protein 1(HMGB1) A-box was produced by gene recombination. HMGB1 A-box and anti-receptor for advanced glycation end products (RAGE) antibody were adopted in the blocking experiments. The importance of DNA for cytokine induction was investigated by DNase treatment.The combination of necrosis supernatant and SLE sera induced the expression of TNF-α and BAFF significantly increased compared to necrosis supernatant or SLE sera alone. Recombinant HMGB1 A-box protein was purified, and TNF-α and BAFF production, which were induced by this combination, was blocked via HMGB1 A-box and anti-RAGE antibody. Moreover, we found that DNA component is important for the immunostimulatory activity of this combination.ICs containing DNA can promote TNF-α and BAFF production in U937 cells, and this process can be mediated by HMGB1 and RAGE. One possible mechanism of increasing BAFF production in SLE is proposed in this study whereby B cell activation, antibody production and ICs stimulated monocytes may create a vicious cycle that leads to B cell hyperactivity, which can be of importance for SLE etiopathogenesis.

The programmable metasurface element is able to achieve continuous controllable responses by loading controllable electronic devices. In this work, a reflective programmable element working at 5GHz is implemented with varactor diodes. By tuning the biasing DC voltage loaded on the varactor diodes, the capacitance can be changed, and then the reflected phases can be tuned. Simulated results show that the reflected phase can cover the 360° and amplitude of the reflective wave is more than 0.7. In order to verify the property of the proposed element, a reflective electronically controllable metasurface is designed based on the proposed element. The metasurface is able to steer the reflective wave from -30° to 30°. The proposed element possesses distinctive features such as simple ultrathin structure, programmable control, and subwavelength, thus exhibiting the promising prospects in agile antennas.

NACHT-LRR-PYD-containing proteins 3 (NLRP3) inflammasome regulates the maturation and secretion of proinflammatory cytokines including interleukin-1β and interleukin-18, as well as immune and inflammatory response, through the activation of cysteine aspartate specific protease-1. Inflammatory response caused by the activation of NLRP3 inflammasome may participate in the development and progression of nonalcoholic fatty liver disease (NAFLD). Therefore, exploration of the role of NLRP3 inflammasome in NAFLD is important for the understanding of the pathogenesis of NAFLD and discovery of new therapeutic targets.