[Research on the determination of the limit value of perchlorate in the "Standards for Drinking Water Quality（GB5749-2022）" in China].

Perchlorate is an environmental pollutant that has been a focus of attention in recent years. It has been detected in many environmental water bodies and drinking water in China, with a high level of presence in some areas of the Yangtze River Basin. The human body may ingest perchlorate through exposure pathways such as drinking water and food, and its main health effect is to affect the thyroid's absorption of iodine. The "Standards for Drinking Water Quality" (GB5749-2022) includes perchlorate as an expanded indicator of water quality, with a limit value of 0.07 mg/L. This article analyzes the technical content related to the determination of hygiene standard limits for perchlorate in drinking water, including the environmental presence level and exposure status of perchlorate, main health effects, derivation of safety reference values, and determination of hygiene standard limits.

[Research on the standard limits for vinyl chloride and trichloroethylene in the "Standards for Drinking Water Quality（GB5749-2022）" in China].

The usage of vinyl chloride and trichloroethylene in China has been increasing year by year, and they have been detected in both drinking water and environmental water, making them important environmental pollutants. Based on the latest research results on the health effects of vinyl chloride and trichloroethylene, the newly issued, "Standards for Drinking Water Quality (GB5749-2022)" in China has adjusted the standard limit of vinyl chloride from 0.005 mg/L to 0.001 mg/L and the standard limit of trichloroethylene from 0.07 mg/L to 0.02 mg/L. This article analyzed and discussed the relevant technical contents for determining the above standard limits, including the levels and exposure conditions of vinyl chloride and trichloroethylene in the water environment, health effects, derivation of safety reference values, and determination of hygiene standard limits. Suggestions were also made for the implementation of this standard.

[Methodological study on the establishment of limit values in the Standards of Drinking Water Quality].

The establishment of limit values for standards of drinking water quality is an important and complex process. This study systematically introduced the methodology of the establishment of standard limit values for drinking water quality and elaborated on the workflow of setting limit values of water quality indicators, principles and methods of selecting water quality indicators, derivation of safety reference values, and establishment of limit values. It also aimed to provide reference and support for the future revision of relevant standards.

[Comparison of three methods for establishing rat peri-implantitis model].

OBJECTIVE: To compare the efficiency and effect of establishing rat peri-implantitis model by traditional cotton thread ligation and local injection of Porphyromonas gingivalis lipopolysaccharide (LPS) around the implant, as well as the combination of the two methods. METHODS: Left side maxillary first molars of 39 male SD rats were extracted, and titanium implants were implanted after four weeks of healing. After 4 weeks of implant osseointegration, 39 rats were randomly divided into 4 groups. Cotton thread ligation (n=12), local injection of LPS around the implant (n=12), and the two methods combined (n=12) were used to induce peri-implantitis, the rest 3 rats were untreated as control group. All procedures were conducted under 5% isoflurane inhalation anesthesia. The rats were sacrificed 2 weeks and 4 weeks after induction through carbon dioxide asphyxiation method. The maxilla of the rats in the test groups were collected and marginal bone loss was observed by micro-CT. The gingival tissues around the implants were collected for further real time quantitative PCR (RT-qPCR) analysis, specifically the expression of tumor necrosis factor-alpha (TNF-α) as well as interleukin-1ß (IL-1ß). The probing depth (PD), bleeding on probing (BOP) and gingival index (GI) of each rat in the experimental group were recorded before induction of inflammation and before death. RESULTS: After 4 weeks of implantation, the osseointegration of implants were confirmed. All the three test groups showed red and swollen gums, obvious marginal bone loss around implants. After 2 weeks and 4 weeks of inflammation induction, PD, GI and BOP of the three test groups increased compared with those before induction, but only BOP was statistically significant among the three test groups (P < 0.05). At the end of 2 weeks of inflammation induction, marginal bone loss was observed at each site in the cotton thread ligation group and the combined group. At each site, the bone resorption in the combined group was greater than that in the cotton thread ligation group, but the difference was not statistically significant (P > 0.05), bone resorption was observed at some sites of some implants in LPS local injection group. At the end of 4 weeks of inflammation induction, marginal bone loss was observed at all sites in each group. The marginal bone loss in the cotton thread ligation group and the combined group was greater than that in the LPS local injection group, and the difference was statistically significant (P < 0.05). At the end of 2 weeks and 4 weeks of induction, the expression of TNF-α and IL-1ß in the test groups were higher than those in the control group (P < 0.05). CONCLUSION: Compared with local injection of LPS around the implant, cotton thread ligature and the two methods combined can induce peri-implantitis in rats better and faster.

[Influencing factors of Legionella reproduction in secondary water supply operation and management].

Objective: To analyze the pollution status and influencing factors of Legionella pneumophila in a secondary water supply facility in a city. Methods: From June to August 2020, a survey on the level of Legionella pneumophila in secondary water supply unit was carried out in a city in northern China, and 304 sets of secondary water supply facilities were included in the study. A total of 760 water samples were collected from the inlet and outlet water of the secondary water supply facilities and some water samples in the water tank were collected for the detection of Legionella pneumophila, standard plate-count bacteria and related physical and chemical indicators. Through questionnaire survey, the basic information of secondary water supply facilities and daily management of water quality were collected. Multivariate logistic regression model was used to analyze the influencing factors of Legionella pneumophila contamination. Results: Among 304 sets of secondary water supply facilities, most of them were located in residential buildings [57.24% (174/304)]. High and low water tank water supply, low water tank variable frequency conversion water supply and non-negative pressure water supply accounted for 26.6% (81/304), 36.8% (112/304) and 36.5% (111/304), respectively. About 25.7% of facilities (78/304) were positive for Legionella pneumophila. Among them, the positive rates of Legionella pneumophila in high and low water tank water supply, low water tank variable frequency conversion water supply and non-negative pressure water supply facilities were 38.3% (31/81), 29.5% (33/112) and 12.6% (14/111), respectively. The results of multivariate logistic regression model analysis showed that the disinfectant residue could reduce the risk of Legionella pneumophila contamination in water samples, and the OR (95%CI) value was 0.083 (0.022-0.317). The increase of the standard plate-count bacteria and conductivity might increase the risk of Legionella pneumophila contamination in water samples. The OR (95%CI) values were 3.160 (1.667-5.99) and 1.004 (1.001-1.006), respectively. Compared with the non-negative pressure water supply, the risk of Legionella pneumophila contamination of secondary water supply facilities was increased by water supply from high and low water tanks and variable frequency conversion water supply from low water tanks, with OR (95%CI) values of 4.296 (2.096-8.803) and 2.894 (1.449-5.782), respectively. Conclusion: The positive rate of Legionella pneumophila in secondary water supply in the study city is high. Disinfectant residue, conductivity and method of water supply are associated with the positive rate of Legionella pneumophila.

[A monogenic lupus family caused by homozygous deletions of DNASE1L3 gene and literature review].

Objective: To report the clinical features and genetic variations of monogenic lupus caused by DNASE1L3 deficiency and to introduce preliminary experience on diagnosis and treatment for this disease. Methods: Clinical data of 3 children from the same pedigree were collected who were diagnosed with DNASE1L3 defect-associated monogenic lupus in August 2020 by Department of Pediatrics, Peking Union Medical College Hospital referred from Department of Pediatrics, Boai Hospital of Zhongshan. DNA was extracted from the peripheral blood of the patients and their parients to perform genetic analysis and confirmation. Six interferon-stimulated genes were relatively quantified to examine the activation of the type I interferon signaling. "DNASE1L3" "systemic lupus erythematosus" and "SLE" were searched in PubMed, Wangfang Data, CNKI databases for related reports from database established date to June 2022. Spectrum of genetic variations and clinical phenotypes were analyzed in combination with this pedigree. Results: Case 1, a 14-year-old girl with edema, hematuria, and heavy proteinuria, presented with membranous nephropathy. Case 2, the 12-year-old younger brother of case 1 with hematologic, cardiac, pulmonary, renal involvement, positive antinuclear antibody, positive anti-double-stranded DNA antibody and low complement C3, manifested with systemic lupus erythematosus. Case 3, the 8-year-old younger sister of case 1 with hematologic, cardiac, pulmonary and renal involvement, positive antinuclear antibody, positive anti-double-stranded DNA antibody, and low complement C3 and C4, manifested with systemic lupus erythematosus. Genetic testing revealed that all 3 patients carried homozygous deletions in exons 3 and 4 on DNASE1L3 gene. Interferon scores were elevated in case 1, 2 and their parents but normal in case 3. All 3 patients were diagnosed with monogenic lupus caused by DNASE1L3 defects. Literature searching identified 10 relevant publications in English and 0 publication in Chinese, involving 42 patients from 18 pedigrees (including the 3 cases from this pedigree). Nine variants were found: c.289_290delAC (p.T97Ifs*2), c.643delT (p.W215Gfs*2), c.320+4delAGTA, c.321-1G>A, Ex5 del, c.433G>A, c.581G>A (p.C194Y), c.537G>A (p.W179X), and Ex3-4 del. The hotspot variants were c.643delT (43% (36/84)) and c.289_290delAC (36% (30/84)). Kidney was affected in 31 cases (74%) of the 42 cases. Among the 25 patients, joints were affected in 16 cases (64%), fever were reported in 13 cases (52%) hematologic system was involved 13 cases (52%), rash was present in 10 cases (40%), intestinal tract was involved in 8 cases (32%), lungs were involved in 6 cases (24%), eyes were involved in 4 cases (16%), and the heart was involved in 4 cases (16%). The 2 cardiopulmonary affected patients from literature showed poor prognosis, with 1 died, and 1 right heart failure. Conclusions: The clinical manifestations of monogenic lupus caused by DNASE1L3 defect are highly heterogenous, primarily with renal, blood, joint, intestinal, and cardiopulmonary involvement. There is no correlation between the genotype and the phenotype. DNASE1L3 defects were predominantly mediated by null varations including nonsense, splicing, frameshift and exon deletions. The hotspot variants are c.643delT and c.289_290delAC. DNASE1L3 defects should be cautioned in early-onset lupus-like patients with renal, joint and hematologic involvement. Cardiopulmonary involved patients require close monitoring for poor prognosis. Copy number variations should be carefully analyzed after negative whole exome sequencing.

[Mechanism of cleft palate in C57BL/6N mice induced by 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin].

Objective: To explore the molecular mechanism of cleft palate in mice induced by 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin (TCDD). Methods: The pregnant mice were randomly divided into TCDD-treated group (n=42) and control group (n=42). TCDD-treated group was given by gavage a single dose of TCDD (64 µg/kg) at 8: 00 AM on gestation day 10 (GD10) and the control group was given by gavage the isopyknic corn oil. At GD13-GD15, the fetal mice palate development was observed by HE staining. The mouse embryonic palatal mesenchymal cell proliferation was detected by 5-bromo-2-deoxyuridine (BrdU) immunofluorescence. The localization and expression of maternally expressed gene3 (MEG3) in mouse embryonic palatal mesenchymal cells was detected by situ hybridization and real-time PCR (RT-PCR). The key protein expressions of transforming growth factor-ß (TGF-ß)/Smad signaling pathway in mouse embryonic palatal mesenchyme were analyzed by Western blotting. The interaction of MEG3 and TGF-ß receptor Ⅰ (TGF-ßRⅠ) was examined by RNA binding protein immunoprecipitation (RIP). Results: At GD13 and GD14, compared with the control group, the ratio of BrdU-positive cells in the palatal mesenchyme of TCDD-treated fetuses decreased significantly (GD13, t=6.66, P=0.003; GD14, t=6.56, P=0.003). However, at GD15, the ratio of BrdU-positive cells was significantly increased (t=-5.98, P=0.004). MEG3 was mainly expressed in the nuclei of fetal mouse palatal mesenchymal cells, and the expression of MEG3 in TCDD group was significantly increased at GD13, GD14 and GD15(GD13, t=39.28, P=0.012; GD14, t=18.75, P=0.042; GD15, t=28.36, P=0.045). At GD14, TCDD decreased the levels of p-Smad2 and Smad4 in embryonic palate mesenchymal cells (p-Smad2, t=9.48, P=0.001;Smad4, t=63.10, P=0.001), whereas the expression of Smad7 was significantly increased at GD14 (t=30.77, P<0.001). The results of the RIP experiment showed that the amount of TGF-ßRⅠ-bound MEG3 in mouse embryonic palatal mesenchymal cells in the TCDD group (23.940±1.301) was higher than that in the control group (8.537±1.523)(t=24.55, P<0.001). Conclusions: MEG3 is involved in the suppression of mouse embryonic palatal mesenchymal cell proliferation, functioning at least in part via interacting with the TGF-ßRⅠ protein and thereby suppressing Smad signaling in the context of TCDD induced cleft palate.

[Clinical outcome of single posterior implant-supported monolithic zirconia crowns fabricated using full digital workflow and conventional workflow: a 3-year follow-up].

Objective: To compare the clinical performance of posterior single implant-supported monolithic zirconia crowns fabricated by full digital workflow and that of those fabricated by conventional workflow. Methods: This is prospective clinical research. Thirty-five patients who participated in a previous study during August 2017 to October 2018 at Department of Prosthodontics, Peking University School and Hospital of Stomatology were included in this 3-year follow-up study. The 35 patients, 17 females and 18 males, aged (49.0±15.4) years (24-86 years old), was allocated into two groups. In the full digital workflow group, intraoral scanning was taken immediately after implant placement, and a full zirconia implant crown was fabricated using model-free computer aided design/computer aided manufacturing (CAD/CAM) procedure (n=14). In the conventional group, a conventional impression was taken 3 months after implant placement and the stone model was produced. A full zirconia implant crown was fabricated using conventional model-based procedure (n=21). Three years following crown delivery, all the prostheses were evaluated in the aspect of color, surface roughness, contour and marginal integrity using modified US Public Health Service criteria (MUSPHS criteria). The soft and hard tissue around implant was evaluated using modified plaque index, probing depth (PD), number of implants with bleeding on probing, marginal bone loss (MBL). The biological and mechanical complication were also recorded. Statistical analysis was performed using independent samples t test, Mann-Whitney U test and Fisher's exact test. Results: The total survival rate of prosthesis and implant was 100% (35/35). No significant difference in MUSPHS criteria ratings on color, surface roughness, contour and marginal integrity of these crowns were found between the full digital workflow group and the conventional group (P>0.05). Sixteen out of the 35 crowns had a contour score of B due to loss of interproximal contact. Ten out of the 35 crowns had the screw hole sealing resin sinking or falling off, four in the full digital workflow group and six in the conventional group. There was no significant difference in the rate of prostheses mechanical complications between the two groups (P=1.000). For all the implants, there was no significant difference in MBL, PD, the modified plaque index, and number of implants with bleeding on probing between the two groups (U=119.50,133.00,142.50, t=-0.53, P>0.05). Conclusions: The clinical performance of implant-supported posterior single monolithic zirconia crowns fabricated by full digital workflow was stable. There was no significant difference in the clinical performance of the single implant crowns between the full digital workflow group and the conventional group.

[Chinese traditional five-tone music therapy].

The ideology of Chinese traditional five-tone music therapy started in the five-tone music practice for witch medicine (Wu Yi) or Shaman medicine (Sa Man Yi Xue) treatment in the primitive period. It came from the five-element thinking, i.e, wood, fire, earth, metal and water which matches each inner organ in the human body to diagnose the lesion of the five main organs in traditional Chinese medicine. The five-tone system diagnoses the lesion of the five inner organs based on the changes of the five tones Jue, Zheng, Gong, Shang and Yu, and the construction of the traditional Chinese medicine theories. It eventually formed in the Yellow Emperor's Internal Classic (Huang Di Nei Jing)during the Warring Period. Chinese traditional five-tone music therapy evolved and developed in each historical dynasty, and laid an ideological and theoretical foundation for contemporary Chinese traditional five-tone music therapy. It helped construct a music therapy as a traditional cultural treasure with unique Chinese cultural characteristics.

[Advances in diagnosis and treatment of acute kidney injury in patients with liver cirrhosis].

Since the 21st century, nephrology and emergency and critical care medicine have proposed the concept of acute kidney injury (AKI), and its core lies in early diagnosis and early treatment to improve prognosis. The concept of AKI has also been used in the diagnosis and treatment of kidney injury in patients with liver cirrhosis. AKI is one of the common complications in patients with decompensated liver cirrhosis, and AKI has unique features in patients with liver cirrhosis. AKI greatly affects the prognosis of patients with liver cirrhosis and increases hospitalization rate and medical burden. This article reviews the advances in the diagnosis and treatment of AKI and hepatorenal syndrome-type AKI in patients with cirrhotic ascites.

Preliminary in vitro analysis of mechanism of cardiac microvascular endothelial barrier function.

To preliminarily clarify the mechanism of cardiac microvascular endothelial barrier function leading to heart failure, primary HMVEC-D cells were selected and cultured for amplification. The cells were infected with adenovirus vector containing the ADP-ribosylation factor 6 (Arf6) Q67L gene. Full-length and functional fragments of myeloid differentiation primary response 88 and ARF nucleotide-binding site opener genes were established and transfected into HEK293T cells. GTP-Arf6 pull-down experiment, fluorescent quantitative real-time PCR, immuno-coprecipitation, and transendothelial electrical resistance analysis were conducted. Interleukin-1ß (IL-1ß) induced increase in vascular permeability, whereas inhibitor SC514 blocked IL-1ß-induced transfer of nuclear factor-κB into the nucleus, from the cytoplasm. Increase in amount of activated Arf6 promoted reduction in transendothelial electrical resistance. In addition, SecinH3 significantly inhibited increase in vascular permeability, and the progression of heart failure was significantly relieved. Cardiac microvascular endothelial barrier function can lead to heart failure. However, IL-1ß induced increase in vascular permeability, which nullified the function of cardiac microvascular endothelial barrier. These findings are closely related to the activation of the Arf6-VE-cadherin signaling pathway.

Low miR-133a expression is a predictor of outcome in patients with esophageal squamous cell cancer.

OBJECTIVE: Identification and development of new biomarkers could be beneficial for diagnosis and prognosis of esophageal squamous cell cancer (ESCC) patients. The aim of this study was to examine the clinical significance of miR-133a expression in tissues from ESCC patients. PATIENTS AND METHODS: Quantitative real-time reverse transcriptive-PCR (qRT-PCR) was performed to examine miR-133a expression levels in 126 ESCC tissues. Survival curves were plotted using the Kaplan-Meier method and differences in survival rates were analyzed using the log-rank test. Univariate and multivariate Cox regression analyses were conducted to determine whether miR-133a was an independent predictor of survival. RESULTS: We found that the levels of miR-133a in ESCC tissues exhibited lower than that in matched normal tissues (p < 0.01). Low miR-133a expression was positively associated with T stage of ESCC (p = 0.013) and tumor length (p = 0.007). Moreover, low levels of miR-133a was associated with lower overall survival (OS) (p = 0.001) and disease-free survival (DFS) (p = 0.001). According to multivariate analysis, miR-133a level was confirmed to be an independent prognostic factor for worse survival. CONCLUSIONS: MiR-133a may represent a prognostic biomarker and therapeutic target in esophageal squamous cell cancer prognosis and treatment.

Association of cytokine gene polymorphisms with susceptibility to invasive candidiasis.

The aim of this study was to investigate the role of cytokine genes in the susceptibility to Candida infection. A total of 275 consecutive patients diagnosed with Candida infection were selected between May 2010 and May 2011, along with 305 uninfected controls. Genotyping of the IL-1ß gene polymorphisms (IL1ß) rs1143634, IL1ßrs16944, IL8 rs4073, IL10 rs1800872, and IL10 rs1800896 was carried out using a 384-well plate format on the Sequenom MassARRAY platform. Patients with invasive Candida infections were more likely to have had an immunocompromised state, hematopoietic stem cell transplantation, solid organ transplant, solid tumor, chemotherapy within the past three months, neutropenia, surgery within the past 30 days, acute renal failure, liver failure, and/or median baseline serum creatinine. Conditional logistic regression analyses found that individuals with the rs1800896 GG genotype were associated with a higher risk of invasive Candida infections than those carrying the AA genotype (odds ratio = 0.61, 95% confidence interval = 0.37-0.94). From the results of this case-control study, we suggest that the cytokine IL-10 gene rs1800896 polymorphism might play a role in the etiology of invasive Candida infections.

Vascularized dorsal digital fascial flap improves flexor tendon repairs.

We report a new method of flexor tendon repair in zone II using a standard modified Kessler technique combined with a vascularized dorsal fascial flap from the finger pedicled on a dorsal cutaneous branch of the proper digital artery, which is placed as a mechanical barrier between the flexor digitorum superficialis and profundus tendons. The functional outcomes of 14 patients (Group A) with flexor tendon repairs in zone II by this new technique were compared with those of 32 patients (Group B) with flexor tendon repairs in zone II using a standard modified Kessler technique only. Patients in Group A had a higher proportion of excellent results (on the modified Strickland system) and more movement in the distal interphalangeal joint than the patients in Group B.

Transmission disequilibrium analysis of the GSN gene in a cohort of family trios with schizophrenia.

Apoptosis is thought to play a role in neuronal pathology in schizophrenia. Recently, the GSN gene was reported to have anti-apoptotic properties. In a genome-wide expression analysis on schizophrenia, GSN was also found to be significantly down-regulated in schizophrenia. All the hints suggest that GSN is a novel candidate gene in occurrence of schizophrenia. In this work, we genotyped 3 SNPs around the GSN locus in 493 sets of the Han Chinese trio sample using allele-specific PCR. A weak association or a marginally positive result was detected (0.05 for P-value of the overtransmitted haplotype and 0.02 for a global P-value).

[A clinical investigation into the effect of comfort denture adhesive on masticatory function with complete dentures].

OBJECTIVE: The purpose of this study was to evaluate the clinical effect of the new developed form of Comfort denture adhesive (Comfort DA). METHODS: 10 edentulous patients with complete dentures were selected for this study. The maximum biting force and masticatory efficiency were recorded before and after application of the adhesive to all the new and old dentures. Subjective test was also used to evaluate this adhesive in enhancing retention and stability of complete denture using the questionnaire way. RESULTS: The data indicated that significantly greater biting forces were generated with old dentures than with the new dentures. The major findings were that the adhesive produced a statistically significant improvement in the masticatory efficiency after application. Subjective views of the patients indicated that this tested product significantly improved denture retention, stability and had other favorable features. The time of adhesion was about 6 8 hours. CONCLUSION: The generally favorable clinical performance of the developed Comfort DA formulation indicated that it might be an efficacious denture adhesive.

[STR polymorphisms in five Chinese ethnic groups(2)].

Population genetic studies were performed in Chinese Han, Hui, Mongolian, Tibetan and Uygur. Allele frequency distributions were analyzed for ten loci, i.e., D3S1358, VWA, CSF1PO, FGA, THO1, TPOX, D5S818, D13S317 and D7S820 by GeneScan. The results showed that there were 60 STR alleles and 149 genotypes in Han; 63 STR alleles and 144 genotypes in Hui; 69 STR alleles and 173 genotypes in Mongolian; 77 STR alleles and 168 genotypes in Tibetan; 70 STR alleles and 148 genotypes in Uygur. Significant differences were identified among ethnic groups (African-American, US-Caucasian and Chinese-Oriental), but similarity was found among the five Chinese populations, and immunogenomics and pharmacogenomics studied in this report. These findings indicated that the nine STR loci and amelogenin locus were very useful for individual identification in forensic science.

[Anti-inflammatory and anti-bacterial functions of bezoar antipyretic tablets].

Bezoar Antipyretic Tablets can inhibit markedly acute exudative inflammation. It can also inhibit markedly drug-resistant Staphylococcus aureus, etc. It has no influence on Bacillus pyocyaneus, etc.