Factors influencing Frey syndrome after parotidectomy with acellular dermal matrix.

BACKGROUND: Frey syndrome, also known as ototemporal nerve syndrome or gustatory sweating syndrome, is one of the most common complications of parotid gland surgery. This condition is characterized by abnormal sensations in the facial skin accompanied by episodes of flushing and sweating triggered by cognitive processes, visual stimuli, or eating. AIM: To investigate the preventive effect of acellular dermal matrix (ADM) on Frey syndrome after parotid tumor resection and analyzed the effects of Frey syndrome across various surgical methods and other factors involved in parotid tumor resection. METHODS: Retrospective data from 82 patients were analyzed to assess the correlation between sex, age, resection sample size, operation time, operation mode, ADM usage, and occurrence of postoperative Frey syndrome. RESULTS: Among the 82 patients, the incidence of Frey syndrome was 56.1%. There were no significant differences in sex, age, or operation time between the two groups (P > 0.05). However, there was a significant difference between ADM implantation and occurrence of Frey syndrome (P < 0.05). ADM application could reduce the variation in the incidence of Frey syndrome across different operation modes. CONCLUSION: ADM can effectively prevent Frey syndrome and delay its onset.

Short- and Long-Term Effects of Different Antibiotics on the Gut Microbiota and Cytokines Level in Mice.

Background: Antibiotics are the first line of treatment for infectious diseases. However, their overuse can increase the spread of drug-resistant bacteria. The present study analyzed the impact of different types of antibiotics on the gut microbiome and cytokines level of mice. Methods: A total of five groups of 8-week-old male BALB/c mice (n = 35) were treated with piperacillin-tazobactam (TZP), ceftriaxone (CRO), tigecycline (TGC), levofloxacin (LEV) or normal saline (Ctrl), respectively, for up to 4 weeks. Fecal samples were analyzed by bacterial 16S rRNA gene sequencing for bacterial identification. Blood samples were used for the determination of 23 serum cytokines using multiplex immunoassay. Results: Exposure to antibiotics was shown to affect the normal weight gain of mice. Significant changes in gut composition caused by TZP, CRO and TGC treatment included the decreased abundance of Bacteroidetes (p < 0.01), Muribaculaceae (p < 0.01) and Lachnospiraceae (p < 0.01), and the increased abundance of Proteobacteria (p < 0.05), Enterobacteriaceae (including Klebsiella and Enterobacter) (p < 0.01) and Enterococcaceae (including Enterococcus) (p < 0.01). After 4-week treatment, the TZP, CRO and LEV groups had significantly lower concentrations of several serum cytokines. Correlation analysis of the top 30 bacterial genera and cytokines showed that Enterococcus and Klebsiella were strongly positively correlated with tumor necrosis factor-α (TNF-α), interleukins (IL) IL-12p70 and IL-1ß. Desulfovibrio, Candidatus Saccharimonas, norank_f__norank_o__Clostridia_UCG-014, Lactobacillus, and Roseburia were strongly negatively correlated with these cytokines. Conclusion: This study demonstrates the effects of various antibiotics on the intestinal microflora and immune status of mice. Compared with TZP, CRO and TGC, LEV had minimal impact on the gut microbiota. In addition to TGC, long-term TZP, CRO and LEV intervention can lead to a decrease in serum cytokine levels, which may depend on the intestinal microflora, antibiotic used and the duration of treatment.

Association between depression and malnutrition in pulmonary tuberculosis patients: A cross-sectional study.

BACKGROUND: Depression has been reported to be prevalent in patients with pulmonary tuberculosis (PTB). Moreover, several clinical symptoms of PTB and depression overlap, such as loss of appetite and malnutrition. However, the association between depression and malnutrition in TB patients has not been fully elucidated. AIM: To explore the association between depression and malnutrition in patients with PTB. METHODS: This hospital-based cross-sectional study included patients with PTB in Shanghai Pulmonary Hospital Affiliated to Tongji University from April 2019 to July 2019. The Patient Health Questionnaire-9 (PHQ-9) scale was used to evaluate depre-ssion. The cut-off value was set at 10, and the nutritional state was determined by the body mass index (BMI). In addition, the Quality of Life Instruments for Chronic Diseases was employed to establish the quality of life (QOL). Univariable analysis and multivariable analysis (forward mode) were implemented to identify the independent factors associated with depression. RESULTS: A total of 328 PTB patients were screened for analysis. Eight were excluded for missing demographic data, four excluded for missing nutrition status, and sixteen for missing QOL data. Finally, 300 PTB patients were subjected to analysis. We found that depressive state was present in 225 PTB patients (75%). The ratio of malnutrition in the depressive PTB patients was 45.33%. Our results revealed significantly lower BMI, hemoglobin, and prealbumin in the depression group than in the control group (P < 0.05). Moreover, the social status differed significantly (P < 0.05) between the groups. In addition, glutamic pyruvic transaminase and glutamic oxaloacetic transaminase in the depression group were significantly higher than those in the control group (P < 0.05). Multivariable logistic regression analysis showed that BMI [odds ratio (OR) = 1.21, 95% confidence interval (CI): 1.163-1.257, P < 0.001] and poor social function (OR = 0.95, 95%CI: 0.926-0.974, P = 0.038) were independently associated with depression. CONCLUSION: Malnutrition and poor social function are significantly associated with depressive symptoms in PTB patients. A prospective large-scale study is needed to confirm these findings.

[Comparison of shaping ability of 4 nickel-titanium rotary instruments in preparation of curved root canals].

PRUPOSE: To compare the shaping ability of 4 nickel-titanium rotary instruments in preparation of curved root canals. METHODS: Forty extracted human maxillary first or second molars with mesiobuccal root canal curvature ranging from 20°-40° were selected. The teeth were randomly equally divided into 4 groups(n=10). Mesial root canals were separately prepared using Protaper Universal, Protaper Next, TF, and S3 nickel-titanium instruments. A series of preoperative and postoperative images were taken by Micro-CT． Mimics 17.0 software was used to analyze the following parameters: canal transportation, centering ratio values, root canal volume, volume of removed dentin, and canal/root width ratio. Data analysis was performed by using SPSS 20.0 software package. RESULTS: In terms of canal transportation after preparation at 1, 3 and 5 mm from the apex, Protaper Universal was more than the other three groups(P＜0.05). The centering ratio value of Protaper Universal was significantly smaller than that of the other three groups at 1 mm from the apex(P＜0.05). The amount of dentin removal was significantly different after instrumentation with the four test systems(P＜0.05). Protaper Universal had the highest mean volume of removed dentin. After preparation, all root canals had a diameter that was not larger than 39% of the root diameter at the coronal and middle segments. CONCLUSIONS: Under the conditions of this study, Protaper Next, TF, S3 systems seem to be better choices than Protaper Universal system in preparing curved root canals.

Interleukin-6 and granulocyte colony-stimulating factor as predictors of the prognosis of influenza-associated pneumonia.

BACKGROUND: Pneumonia is a common complication of influenza and closely related to mortality in influenza patients. The present study examines cytokines as predictors of the prognosis of influenza-associated pneumonia. METHODS: This study included 101 inpatients with influenza (64 pneumonia and 37 non-pneumonia patients). 48 cytokines were detected in the serum samples of the patients and the clinical characteristics were analyzed. The correlation between them was analyzed to identify predictive biomarkers for the prognosis of influenza-associated pneumonia. RESULTS: Seventeen patients had poor prognosis and developed pneumonia. Among patients with influenza-associated pneumonia, the levels of 8 cytokines were significantly higher in those who had a poor prognosis: interleukin-6 (IL-6), interferon-γ (IFN-γ), granulocyte colony-stimulating factor (G-CSF), monocyte colony-stimulating factor (M-CSF), monocyte chemoattractant protein-1 (MCP-1), monocyte chemoattractant protein-3, Interleukin-2 receptor subunit alpha and Hepatocyte growth factor. Correlation analysis showed that the IL-6, G-CSF, M-CSF, IFN-γ, and MCP-1 levels had positive correlations with the severity of pneumonia. IL-6 and G-CSF showed a strong and positive correlation with poor prognosis in influenza-associated pneumonia patients. The combined effect of the two cytokines resulted in the largest area (0.926) under the receiver-operating characteristic curve. CONCLUSION: The results indicate that the probability of poor prognosis in influenza patients with pneumonia is significantly increased. IL-6, G-CSF, M-CSF, IFN-γ, and MCP-1 levels had a positive correlation with the severity of pneumonia. Importantly, IL-6 and G-CSF were identified as significant predictors of the severity of influenza-associated pneumonia.

Risk factors analysis of COVID-19 patients with ARDS and prediction based on machine learning.

COVID-19 is a newly emerging infectious disease, which is generally susceptible to human beings and has caused huge losses to people's health. Acute respiratory distress syndrome (ARDS) is one of the common clinical manifestations of severe COVID-19 and it is also responsible for the current shortage of ventilators worldwide. This study aims to analyze the clinical characteristics of COVID-19 ARDS patients and establish a diagnostic system based on artificial intelligence (AI) method to predict the probability of ARDS in COVID-19 patients. We collected clinical data of 659 COVID-19 patients from 11 regions in China. The clinical characteristics of the ARDS group and no-ARDS group of COVID-19 patients were elaborately compared and both traditional machine learning algorithms and deep learning-based method were used to build the prediction models. Results indicated that the median age of ARDS patients was 56.5 years old, which was significantly older than those with non-ARDS by 7.5 years. Male and patients with BMI > 25 were more likely to develop ARDS. The clinical features of ARDS patients included cough (80.3%), polypnea (59.2%), lung consolidation (53.9%), secondary bacterial infection (30.3%), and comorbidities such as hypertension (48.7%). Abnormal biochemical indicators such as lymphocyte count, CK, NLR, AST, LDH, and CRP were all strongly related to the aggravation of ARDS. Furthermore, through various AI methods for modeling and prediction effect evaluation based on the above risk factors, decision tree achieved the best AUC, accuracy, sensitivity and specificity in identifying the mild patients who were easy to develop ARDS, which undoubtedly helped to deliver proper care and optimize use of limited resources.

Effect of the Short-Term Use of Fluoroquinolone and ß-Lactam Antibiotics on Mouse Gut Microbiota.

BACKGROUND: Antibiotics play an important role in the treatment of infectious diseases. However, the overuse of antibiotics increases the spread of drug-resistant bacteria and causes dysbiosis of the intestinal microbiota. Few studies have addressed the longitudinal effects of antibiotics on the microbiome and host immunity. MATERIALS AND METHODS: In this study, the short-term effect of fluoroquinolone (levofloxacin) and ß-lactam antibiotics (meropenem, cefoperazone/sulbactam, and aztreonam) on the gut microbiota of mice was evaluated by 16S rRNA gene sequencing. The susceptibility of Bifidobacterium longum, Lactobacillus lactis, Enterococcus faecium, and Clostridium butyricum to these antimicrobial agents was assessed using the disc diffusion method. RESULTS: Our results showed that 4-day antibiotic exposure significantly reduced the alpha and beta diversity of gut bacteria and increased serum inflammatory cytokines, and these changes persisted long after antibiotic withdrawal and did not return to pre-treatment levels. Nonetheless, the bacterial community composition tended to return to pre-treatment levels after discontinuing treatment. The tested probiotic strains were resistant to aztreonam but were sensitive to meropenem and cefoperazone/sulbactam. CONCLUSION: Short-term antibiotic treatment led to significant changes in the intestinal flora with a tendency to recover. The antibiotics had different effects on the intestinal microbial community and probiotic strains. This study provides guidance for the concomitant use of probiotics and antibiotics, and the results emphasize the importance of using broad-spectrum antibiotics responsibly to prevent the long-term disruption of the native microbiota.

Cross-cultural adaptation, validity, and reliability of the Chinese version of the Nurses' Perceptions of Disaster Core Competencies Scale (NPDCC).

BACKGROUND: In recent years, disasters occurred frequently all over the world, and the role of nurses in public health emergencies and disaster emergencies was highlighted under the background of the covid19 epidemic. However, there was a lack of education and evaluation. Our study aims to cross-cultural adapt the Nurses' Perceptions of Disaster Core Competencies Scale (NPDCC) and evaluate the reliability and validity of the Chinese version. METHODS: We translated the scale following the translation-integration-back translation-expert review procedure, adapted according to Chinese culture. We evaluated the reliability and validity of the scale, and a total sample of 911 nurse data from the Yangtze River Delta Regional Nursing Alliance Hospital was gathered. RESULTS: The Chinese version of NPDCC included 45 items, 5 factors (critical thinking skills, special diagnostic skills, general diagnostic skills, technical skills, and communication skills) were extracted from the analysis, which could explain the 68.289% of the total variance. The content validity index was 0.925. The Cronbach's α of the total NPDCC score was 0.978, and 0.884-0.945 for every factor. The split-half for the scale was 0.930, and every factor was 0.861-0.894. CONCLUSIONS: The Chinese version of NPDCC has excellent reliability and validity, and it is suitable to measure nurses' perceptions of disaster core competencies in China. The next step is to promote the application in a large scale.

Nasopharyngeal Epstein-Barr virus DNA loads in high-risk nasopharyngeal carcinoma families: Familial aggregation and host heritability.

Nasopharyngeal carcinoma (NPC), the most common head and neck cancer, is characterized by distinct geographic distribution and familial aggregation. Multiple risk factors, including host genetics, environmental factor, and EBV infection, have been linked to the development of NPC, particularly in the familial clustering cases. However, the cause of NPC endemicity remains enigmatic due possibly to the complicated interplay between these risk factors. Recently, positive Epstein-Barr virus (EBV) DNA loads at nasopharyngeal (NP) cavity has been found to reflect NPC development and applied in NPC screening. To examine whether the increased NP EBV loads could aggregate in the families and be affected by host genetics and environmental factor, EBV loads were obtained by 510 NP brushing samples from eligible unaffected individuals, who have two or more relatives affected with NPC, in 116 high-risk NPC families. The correlation of relative pairs was estimated using S.A.G.E. (version 6.4, 2016), and host heritability of NP EBV loads was calculated with variance component models using SOLAR (version 8.4.2, 2019). In result, significant correlations of EBV loads were observed between parent-offspring pairs and sibling-sibling pairs (P < .001), but not in distant kin relationship pairs. Interestingly, after excluding the shared environmental factor within families, host genetics contributes significantly to NP EBV loads with a heritability of 56.41% (P = 1.00 × 10-7 ), and its effect was slightly elevated (68.86%, P = 3.40 × 10-6 ) in families with more NPC cases (≥3). These findings indicate that additional host-genetic variants involved in the EBV local NP mucosal behavior may be especially important for the development of NPC.

Serum chitinase-3-like protein 1 is a biomarker of liver fibrosis in patients with chronic hepatitis B in China.

BACKGROUND: Serum chitinase-3-like protein 1 (CHI3L1) is a potential biomarker for fibrosis assessment. We aimed to evaluate serum CHI3L1 as a noninvasive diagnostic marker for chronic hepatitis B virus-related fibrosis. METHODS: Serum CHI3L1 levels were measured by ELISA in 134 chronic hepatitis B (CHB) patients. Significant fibrosis was defined as a liver stiffness > 9.7 kPa. The performance of CHI3L1 was assessed and compared to that of other noninvasive tests by receiver operating characteristic (ROC) analysis. RESULTS: Serum CHI3L1 levels were significantly higher in CHB patients with significant hepatic fibrosis (≥ F2, 81.9 ng/mL) than in those without significant hepatic fibrosis (< F2, 56.5 ng/mL) (P < 0.001). In CHB patients, the specificity and sensitivity of CHI3L1 for predicting significant fibrosis were 75.6% and 59.1%, respectively, with a cut-off of 76.0 ng/mL and an area under the ROC curve of 0.728 (95% CI: 0.637-0.820). CONCLUSIONS: Serum CHI3L1 levels could be an effective new serological biomarker for the diagnosis of liver. Moreover, CHI3L1 is feasible in monitoring disease progression.

Positron-emitting tracer imaging of fluoride transport and distribution in tea plant.

BACKGROUND: Tea (Camellia sinensis (L.) O. Kuntze) is a hyper-accumulator of fluoride (F). To understand F uptake and distribution in living plants, we visually evaluated the real-time transport of F absorbed by roots and leaves using a positron-emitting (18 F) fluoride tracer and a positron-emitting tracer imaging system. RESULTS: F arrived at an aerial plant part about 1.5 h after absorption by roots, suggesting that tea roots had a retention effect on F, and then was transported upward mainly via the xylem and little via the phloem along the tea stem, but no F was observed in the leaves within the initial 8 h. F absorbed via a cut petiole (leaf 4) was mainly transported downward along the stem within the initial 2 h. Although F was first detected in the top and ipsilateral leaves, it was not detected in tea roots by the end of the monitoring. During the monitoring time, F principally accumulated in the node. CONCLUSION: F uptake by the petiole of excised leaf and root system was realized in different ways. The nodes indicated that they may play pivotal roles in the transport of F in tea plants. © 2020 Society of Chemical Industry.

Muscle weakness associated with H7N9 infection: report of two cases.

BACKGROUND: The emerging avian influenza A (H7N9) virus, a subtype of influenza viruses, was first discovered in March 2013 in China. Infected patients frequently present with pneumonia and acute respiratory disorder syndrome with high rates of intensive care unit admission and death. Neurological complications, such as Guillain-Barré syndrome(GBS), and intensive care unit-acquired weakness, including critical illness polyneuropathy and myopathy, have only rarely been reported previously. CASE PRESENTATION: In this study, we report on two Chinese patients with H7N9 severe pneumonia presenting neurological complications. These two patients had non-immune diseases prior to the onset of virus infection. A 56-year-old female patient (case 1) and a 78-year-old female patient (case 2) were admitted because of fever, cough, chest tightness and shortness of breath. These patients were confirmed to have H7N9 infection soon after admission followed by the development of acute respiratory distress syndrome and various severe bacterial and fungal infections. The case 1 patient was found to have muscle weakness in all extremities after withdrawing the mechanical ventilator, and the case 2 patient was found when withdrawing extracorporeal membrane oxygenation, both of these conditions prolonged ventilator-weaning time. Furthermore, the case 1 patient carried the H7N9 virus for a prolonged period, reaching 28 days, and both of them stayed in the hospital for more than two months. A clinical diagnosis of intensive care unit-acquired weakness could be confirmed. However, based on results from electrophysiological testing and needle electromyography of these 2 patients, it is difficult to differentiate critical illness polyneuropathy from GBS, since no lumbar puncture or muscle and nerve biopsy were conducted during hospitalization. Following a long-term comprehensive treatment, the patients' neurological condition improved gradually. CONCLUSIONS: Although there is great improvement in saving severe patients' lives from fatal respiratory and blood infections, it is necessary to pay sufficient attention and to use more methods to differentiate GBS from intensive care unit-acquired weakness. This unusual neurological complication could result in additional complications including ventilator associated pneumonia, prolonged hospital stay and then would further increase the death rate, and huge costs.

Molecular epidemiology and antimicrobial susceptibility of Clostridium difficile isolated from hospitals during a 4-year period in China.

OBJECTIVE: The aim of this study was to perform molecular characterization for and determine the antimicrobial susceptibility profiles of Clostridium difficile collected from hospitals during a 4-year period (2009-2013) in China. METHODS: Strains of toxigenic C. difficile were isolated from patients with diarrhoea, and this was followed by typing using multilocus sequence typing (MLST) and testing for susceptibility to 10 antimicrobials by using the E-test. The mechanisms of resistance to moxifloxacin, erythromycin, clindamycin and tetracycline were investigated by PCR. RESULTS: A total of 405 non-duplicate toxigenic C. difficile isolates were identified, while 31 sequence types (STs) were identified. A predominant type, ST-54, accounted for 20.2 % of the STs, followed by ST-35 (16.3 %) and ST-37 (13.6 %). We found that 6.2 % of the isolates were binary toxin genes-positive, and 83.7 % of these belonged to ST-5. All of the isolates demonstrated 100 % susceptibility to first-line Clostridium difficile infection (CDI) therapies (i.e. metronidazole and vancomycin), while the resistance rates varied for the other antibiotics tested. Two hundred and ninety three (72.3 %) isolates were susceptible to moxifloxacin. All 112 moxifloxacin-resistant isolates had mutations resulting in an amino acid substitution in gryA and/or gyrB. The ermB gene was detected in 86.7 % (241/278) of the erythromycin- and clindamycin-resistant isolates, while the tetM gene was present in 97.1 % (85/87) of the tetracycline-resistant isolates. CONCLUSION: MLST typing revealed a wide variety of STs causing CDI, while ST-54 was the most common ST. All of the isolates were susceptible to metronidazole and vancomycin, while the resistance rates varied for the other antibiotics tested. There were no changes in the trends for the STs and antibiotic susceptibility profiles over 4 years.

3,4-oxo-isopropylidene-shikimic acid inhibits cerebral ischemia-induced oxidative stress and neuronal apoptosis in rats.

BACKGROUND: To investigate the potential protective effects of 3,4-oxo-isopropylidene-shikimic acid (ISA) on brain ischemic injury in rats. METHODS: Cell Counting Kit-8, flow cytometry, and TUNEL were used to evaluate the cell viability and the apoptosis rate in vitro and in situ. Reactive oxygen species generation was determined by DCFH-DA assay. qPCR and Western blot were used to test the molecular mechanisms related to the anti-apoptosis effects. RESULT: Protective effect of pre-conditioning of ISA on the brain injury caused by ischemia was observed. ISA treatment showed anti-apoptosis effects on isolated primary astrocytes and neurons. ROS generation was also significantly scavenged by treatment of ISA. The treatment with ISA protected astrocytes from hypoxic condition-induced apoptosis and ischemic injury. The underlying mechanisms revealed by qPCR and WB showed that the level of mRNA and protein expression of Bax, Bcl-2, and caspase-3 were significantly down-regulated by ISA treatment (P < 0.05). Pre-conditioning with ISA is beneficial in reducing the neuronal damage caused by brain ischemia. CONCLUSION: Treatment with ISA reduces apoptosis and ROS over-generation caused by ischemic injury. Pre-conditioning with ISA resulted in significantly protective effects on brain under ischemic condition.

XPG gene polymorphisms and cancer susceptibility: evidence from 47 studies.

Xeroderma pigmentosum group G (XPG) is a single-strand-specific DNA endonuclease that functions in the nucleotide excision repair pathway. Genetic variations in XPG gene can alter the DNA repair capacity of this enzyme. We evaluated the associations between six single nucleotide polymorphisms (SNPs) in XPG (rs1047768 T>C, rs2296147 T>C, rs2227869 G>C, rs2094258 C>T, rs751402 C>T, and rs873601 G>A) and cancer risk. Forty-seven studies were identified in searches of the PubMed, Scopus, Web of Science, China National Knowledge Infrastructure, and WanFang databases. Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a fixed or random effects model. We found that rs873601 G>A was associated with an increased overall cancer risk (AA vs. GG: OR = 1.14, 95% CI = 1.06-1.24; GA/AA vs. GG: OR = 1.08, 95% CI = 1.02-1.15; A vs. G: OR = 1.06, 95% CI = 1.02-1.10). In a stratified analysis, rs1047768 T>C was associated with an increased risk of lung cancer, rs2227869 G>C was associated with a decreased risk of cancer in population-based studies, and rs751402 C>T and rs873601 G>A were associated with the risk of gastric cancer. Our data indicate that rs873601 G>A is associated with cancer susceptibility.

Global trends in incidence and mortality of nasopharyngeal carcinoma.

Nasopharyngeal carcinoma (NPC) is a rare malignancy with an extraordinarily skewed geographic distribution worldwide. Although decreasing trends in incidence and mortality of NPC have been sporadically reported in some high-risk areas, no comprehensive description of the global trends has ever been made. We accessed incidence (1970-2007) and mortality (1970-2013) data from multiple sources, with the main ones being the Cancer Incidence in Five Continents (CI5) series and the World Health Organization (WHO) cancer mortality database. During the entire period studied, age-standardized incidence rates (ASIRs) of NPC decreased significantly in southern and eastern Asia, north America and Nordic countries with average annual percent changes (AAPCs) of -0.9% to -5.4% in males and -1.1% to -4.1% in females. Declines in age-standardized mortality rates (ASMRs) are even more remarkable and extensive, with AAPCs varying from -0.9% and -0.8% to -3.7% and -6.5% in males and females, respectively. Decreasing trends in NPC incidence are probably due to tobacco control, changes in diets and economic development. Declines in mortality rates are the results of advancements in diagnostic and radiotherapy techniques, as well as decreased incidence rates.

Household inhalants exposure and nasopharyngeal carcinoma risk: a large-scale case-control study in Guangdong, China.

BACKGROUND: Epidemiological studies show that cigarette smoking increase the risk of nasopharyngeal carcinoma (NPC), however, whether other common, potentially adverse household inhalants increase NPC risk remains uncertain. METHODS: We conducted a large case-control study to explore the effects of household inhalants, such as incense, mosquito coil, cooking fumes, and wood combustion, on NPC risk. We recruited 1,845 cases and 2,275 controls from Guangdong province, a high-risk area for NPC in China, to obtain the demographic data and relevant exposure information through face-to-face interviews. RESULTS: We found that incense burning was associated with NPC risk by comparing frequent incense use with never using incense [OR and 95% confidence interval (CI) = 1.73, (1.43, 2.09)]. Wood fuel use was also associated with NPC risk compared with non-wood fire use [OR and 95% CI = 1.95, (1.65, 2.31)]. More intriguingly, we observed a significant addictive interaction between frequent incense burning and heavy cigarette smoking on NPC risk [synergistic index (SI) = 1.67; 95% CI: 1.01, 2.76]. We also found a significant joint effect between wood fuel use and NPC family history for NPC risk (SI = 1.77; 95% CI: 1.06, 2.96). However, neither mosquito oil nor cooking fumes were associated with NPC risk. CONCLUSIONS: Our study shows that incense smoke is not only the potential independent risk factor but also co-contributes with cigarette smoking to NPC risk. Moreover, wood combustion is another potential environmental risk factor and exerts a joint effect with NPC family history on NPC.

[Expression of ß-catenin in the apical papilla and dental pulp tissues of human permanent teeth].

PURPOSE: The expression of ß-catenin at the level of mRNA and protein in the apical papilla and dental pulp tissues of human permanent teeth were compared to explore the possible relationship between ß-catenin and the development of pulp-dentin complex. METHODS: Forty-eight healthy permanent teeth in need of extraction for orthodontic treatment were obtained. The apical papilla and dental pulp tissues were isolated immediately when the teeth were extracted. All the samples were divided into 3 groups: group1, apical papilla of immature permanent teeth; group 2, dental pulp tissues of immature permanent teeth; group 3, dental pulp tissues of mature permanent teeth. RT-PCR and Western blot techniques were used to examine the expression of ß-catenin at the level of mRNA and protein respectively. Meta Morph software was used to measure the gray value of the positively expressed bands. Two-sample t test was performed to analyze the expression intensity (gray value) of ß-catenin by use of SPSS 11.0 software package. RESULTS: ß-catenin was positively expressed at both mRNA level and protein level in all the samples investigated. The expression intensity of ß-catenin in the dental pulp tissues of human immature permanent teeth was higher than that in the apical papillary tissues and that in the dental pulp tissues of human mature permanent teeth as well. The differences were statistically significant (P<0.05). CONCLUSIONS: ß-catenin was expressed in both the apical papilla and dental pulp tissues of immature and mature permanent teeth, but the expression intensity was different. It indicated that ß-catenin may play an important role in the development of pulp-dentin complex and in the reparative process after the dental pulp injury.

Effects of tetrahydrobiopterin on cerebral infarction after transient focal ischemia in rats.

OBJECTIVES: The present study investigated the effects of tetrahydrobiopterin (BH4) on cerebral infarction after transient focal ischemia in rats. METHODS: Focal ischemia (1·5 hours) was created in male Sprague-Dawley rats (250-280 g) by middle cerebral artery occlusion. Some rats were treated with 20 mg/kg tetrahydrobiopterin by intraperitoneal injection 30 minutes before reperfusion. At 2, 6, and 12 hours of reperfusion, the brains were harvested for the nitric oxide synthase (NOS) activity and nitric oxide (NO) level assays. At 12 hours of reperfusion, the brains were harvested for infarct size measurement. RESULTS: NOS activity and NO level were all augmented after reperfusion. BH4 treatment significantly further increased NOS activity and NO level. Cerebral infarct size was significantly bigger in BH4 treatment group compared to that in no treatment group. CONCLUSIONS: The data indicate that BH4 enhances cerebral infarction after transient focal ischemia in rats, through NOS and NO pathway.

Treatment of hypertensive intracerebral hemorrhage through keyhole transsylvian approach.

The present study investigated the therapeutic effects and indications of keyhole transsylvian approach (KTA) in the treatment of hypertensive intracerebral hemorrhage (HICH). Clinical data of 65 cases of HICH were retrospectively analyzed. All the patients were treated by open surgical evacuation either through KTA (KTA group) or through conventional craniotomy approach (CCA group). The operative time, intraoperative bleeding quantity, the length of hospitalization, mortality, and favorable outcome were compared between the 2 groups. Compared with the CCA group, the KTA group had smaller bleeding quantity and shorter length of hospitalization. Favorable outcome at 3 months after admission was higher in the KTA group than that in the CCA group. The present study suggests that treatment of HICH through KTA is a practical and effective surgical procedure.