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Pelvic floor dysfunction is a group of clinical syndromes that occur due to structural damage and dysfunction of the pelvic floor.These syndromes include pelvic organ prolapse, urinary incontinence and pelvic pain.Elderly women have a high prevalence of pelvic floor dysfunction, with approximately 50% being affected.The symptoms of this condition have a significant impact on the quality of life in the elderly population.Therefore, it is crucial to evaluate the severity of symptoms and their impact for the diagnosis and treatment of pelvic floor dysfunction in elderly women.To aid in this evaluation, symptom and quality of life questionnaires are important tools in clinical care.However, the wide range of clinical questionnaires available for pelvic floor dysfunction, which are not specifically tailored to elderly women, has caused confusion among clinicians regarding their selection, utilization, and evaluation.This article utilizes CiteSpace to identify key research areas and frequently used questionnaires in the field.It also introduces methods for applying and assessing symptom and quality of life surveys, with the aim of enhancing clinicians' proficiency in evaluating pelvic floor dysfunction, particularly in elderly women.
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BACKGROUND:Combining seed cells with 3D bioprinting technology enables the specific construction of various tissues and organs to meet the demands of tissue repair.However,further research is needed on the promotion of angiogenesis in damaged tissues. OBJECTIVE:By cultivating a 3D scaffold structure of methacrylated gelatin loaded with fibroblasts,obtaining the supernatant,and mixing it in different proportions with a complete culture medium to simulate the cellular microenvironment during tissue repair,this study aimed to explore the role of various cellular microenvironments in promoting angiogenesis in endothelial cells. METHODS:A methacrylated gelatin scaffold structure loaded with fibroblasts was prepared using an extrusion-based 3D bioprinting process.Hydrogel scaffold extract was prepared and mixed with a complete culture medium in ratios of 1:1,1:2,and 1:4 to obtain conditioned medium.Mouse embryonic fibroblasts BALB3T3 and human umbilical vein endothelial cells were co-cultured with complete medium(control group)and hydrogel scaffold extract,respectively.Cell proliferation was assessed using the CCK-8 assay and cell viability was analyzed using live/dead staining.Three kinds of conditioned medium and complete medium(control group)were used to co-culture with human umbilical vein endothelial cells for tube formulation assay,vascular genetic testing,and immunofluorescence staining of CD31. RESULTS AND CONCLUSION:(1)Scanning electron microscopy revealed that the methacrylated gelatin scaffold exhibited a porous structure,and rheological results demonstrated excellent mechanical properties of the hydrogel.CCK-8 assay and live/dead cell staining showed that the hydrogel scaffold extract had no obvious cytotoxicity.(2)Tube formulation assay indicated that the hydrogel showed the total length of cell tubules in 1:1 conditioned medium group was smaller than that in the control group(P<0.05).There were no statistical differences among the four groups in the number of vascular branches formed by endothelial cells(P>0.05).(3)qRT-PCR results showed that for vascular endothelial growth factor mRNA expression,the 1:2 conditioned medium group was lower than the 1:1 conditioned medium group on day 1(P<0.01).On day 3,the expression level of vascular endothelial growth factor in the 1:2 conditioned medium group was higher than that in the control group(P<0.01).On day 5,the cytokine expression level in the 1:2 conditioned medium group was significantly higher than that in the other three groups(P<0.01 or P<0.000 1).The expression in the 1:1 conditioned medium group was significantly lower than that in the other three groups(P<0.05 or P<0.01).On day 1,the expression level of basic fibroblast growth factor in the 1:1 conditioned medium group was significantly higher than that in the control group and 1:4 conditioned medium group(P<0.01,P<0.05).The expression was higher in the 1:2 conditioned medium group than that in the control group(P<0.05).On day 3,the expression levels of cytokines in the 1:4 conditioned medium group was higher than that in the control group(P<0.05).(4)On day 3,the expression of CD31 in the 1:2 conditioned medium group was higher than that in the control group and the 1:4 conditioned medium group(P<0.05).(5)The results indicate that the resulting conditioned media can simulate the microenvironment of vascular regeneration after tissue damage,promoting the vascularization process of endothelial cells.The best promotion of vascularization in endothelial cells was observed when the ratio of supernatant to complete culture medium was 1:2.
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Background Lead is widely distributed. Lead exposure interferes with early life development in zebrafish, but the mechanisms by which lead exposure affects skeletal development and cardiac development are not clear as yet. Objective To investigate the molecular mechanisms of bone development and cardiac development toxicity induced by lead acetate exposure. Methods Zebrafish embryos were exposed to different concentrations of lead acetate (0, 6, 12, 24, and 48 μmol·L−1) for 3 h post-fertilization (3 hpf) until 5 d post-fertilization (5 dpf). The malformation phenotypes of 5 dpf were counted, and the mRNA expressions of spinal development-related genes (bmp2b, bmp4, bmp9, runx2a, runx2b) and heart development-related genes (nkx2.5, myh6, myh7) were detected by quantitative PCR (qPCR). Expressions of genes of development-related regulatory pathways including Wnt/β-catenin pathway (wnt5a, wnt8a, wnt10a, β-catenin) and TGF-β pathway (tgf-β1, tgf-β2) as well as key molecule eph of Eph-Ephrin signaling were analyzed. Results At 5 dpf, the zebrafish in the lead acetate treated groups showed deformed phenotypes including spinal curvature and pericardial sac edema compared to the control group. In the lead acetate groups at 24 and 48 μmol·L−1, the spinal curvature deformity rates reached 26.47% and 71.52% (P<0.01) respectively. The qPCR results revealed that the expression levels of spinal development-related genes bmp2b, bmp4, bmp9, runx2a, and runx2b were downregulated in the 48 μmol·L−1 exposure group compared to the control group by 82.8%, 58.0%, 88.7%, 85.5%, and 69.2%, respectively (P<0.05 or P<0.01); the expression levels of heart development-related genes myh6, myh7, and nkx2.5 were down-regulated by 63.7%, 58.9%, and 55.2%, respectively (P<0.01); the expression levels of wnt8a and β-catenin in the Wnt/β-catenin pathway were down-regulated by 71.5% and 47.3% (P < 0.05 or P < 0.01), respectively; the expression level of tgf- β1 in the TGF-β pathway was down-regulated by 67.5% (P<0.01); the expression level of eph was down-regulated by 86.9% (P<0.01). Conclusion Lead acetate exerts developmental toxic effects on zebrafish heart and bone by down-regulating the expressions of genes related to spinal development and heart development, as well as inhibiting development-related Wnt/β-catenin and TGF-β pathways and Eph-Ephrin signaling, causing malformed phenotypes such as spinal curvature and pericardial sac edema.
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Objective:Based on the principle of neuroplasticity, to explore the effect of square dancing on elderly patients with subjective cognitive decline (SCD).Methods:SCD patients in the main urban area of Nanjing were selected in this quasi experimental research from March to September 2022 and divided into experimental group and control group according to whether the subjects were willing to participate in square dance intervention, with 30 cases in each group. The experimental group received 6 months of square dancing intervention, and the control group received routine nursing. The differences of cognition, memory, language, executive ability, daily living ability and anxiety and depression were compared between the two groups.Results:Twenty-seven cases in the experimental group and 28 cases in the control group completed the intervention. After intervention, the scores of Montreal Cognitive Assessment Scale-15, the Geriatric Depression Scale, Hamilton Anxiety Scale and Trail Making Test B were 27.0(26.0, 28.0), 2.0(1.0, 4.0), (4.30 ± 2.04) points and (112.48 ± 25.42) seconds, respectively. Compared with the control group of 26.0 (24.0, 27.0), 4.0 (2.0, 5.8), (5.89 ± 1.45) points and (133.21 ± 32.39) seconds, the differences were statistically significant ( Z = -2.24, -2.72, t = - 2.05, -2.64, all P<0.05). Conclusions:Square dancing can improve the cognitive function of elderly patients with SCD, promote the improvement of memory, language, executive function and daily living ability, and effectively relieve anxiety and depression symptoms.
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Objective:To explore the effectiveness of PDCA (plan, do, check, action) cycle management method in improving the completion rate of after-department examination in pediatric professional base.Methods:Through the residency management system platform, the completion rate of after-department examination from February 2019 to March 2019 differed greatly. Referring to the PDCA cycle management methods, according to the analysis of fishbone diagram, relevant reasons were obtained and a series of rectification measures were implemented including the formulation of relevant programs from the four aspects such as department, resident, rules and regulations and tools. The rectification courses were taken for 5 months. SPSS 17.0 was used for Chi-square test.Results:April to August 2019 was the main rectification execution stage, during which the monthly completion rate of after-department examination increased, but fluctuated (66.70%-89.70%).Compared with the rectification courses before (in February), the completion rate of after-department examination was significantly increased after rectification (in October) [(96.00%) vs. (42.11%)], with statistical significance ( P < 0.01). Conclusion:PDCA cycle management method can effectively improve the completion rate of after-department examination in pediatric professional base, which should be further widely promoted.
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This article reported the prenatal diagnosis of a fetus with ZTTK syndrome. A pregnant woman underwent preimplantation genetic diagnosis because her partner carried a balanced chromosomal translocation. Chromosomal karyotype analysis and copy number variation sequencing (CNV-seq) performed on amniocytes collected at 18 + weeks of gestation revealed no abnormalities. Ultrasonography performed at 23 +5 and 26 +3 weeks of gestation revealed severe fetal growth restriction, cerebellar dysplasia, poorly visualized sacrum and coccyx, and spina bifida. MRI of the fetal brain showed that the bilateral cerebellar hemispheres of the fetus were small and the cisterna magna was large at 23 +6 weeks of gestation. Whole exome sequencing in the pedigree identified a heterozygous variant c.2092delG (p.Glu698fs*4) in the exon 3 of the fetal SON gene, which was not inherited from the parents and proved to be a de novo mutation. Mutations in the locus are pathogenic, causing ZTTK syndrome. After genetic counseling, the pregnant woman and her family chose to terminate the pregnancy.
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Colorectal cancer is one of the common malignant tumors with high morbidity， and changes in lifestyle， dietary structure and environment in China in recent decades have been associated with an increase in the incidence of colorectal cancer. A large number of studies have shown that traditional Chinese medicine（TCM） can be used as a complementary and alternative treatment for colorectal cancer after conventional western medicine treatment. TCM physicians have accumulated a lot of clinical experience in the treatment of patients with stage Ⅰ-Ⅲ colorectal cancer， and have proved that TCM has unique efficacy， but there is still a lack of relevant clinical practice guidelines to standardize and guide the diagnosis and treatment of TCM. Based on this， according to the guideline development process of the World Health Organization Handbook for Guideline Development and the Clinical Evidence Grading Criteria on TCM Based on Evidence Body， under the framework of relevant laws， regulations and technical guidance documents， combined with the evidence of relevant domestic and foreign clinical research in recent years for evidence grading and opinion recommendation， and then the Guidelines for TCM Intervention After Conventional Western Medicine Treatment for Stage Ⅰ-Ⅲ Colorectal Cancer were developed by expert consensus. This guideline introduces the etiology， pathogenesis， syndrome differentiation and treatment of TCM intervention for colorectal cancer， which can provide guiding opinions for TCM clinicians and clinicians of integrated traditional Chinese and western medicine engaged in the prevention and treatment of colorectal cancer.
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Objective@#To investigate immune responses to influenza virus infections and the immunogenicity of trivalent split-virus influenza vaccine among elderly populations in Jiangbei District, Ningbo City, so as to provide the support for promoting influenza vaccination among elderly populations.@*Methods@#The elderly populations at ages of 60 years and older were recruited in Jiangbei District of Ningbo City from September to November, 2020, and the participants were assigned to the vaccination group and the control group according to vaccination intention. The titers of haemagglutination inhibition ( HI ) antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were measured using the micro HI test prior to vaccination and 30 days post-vaccination, and the protective rate, geometric mean titer ( GMT ) and seroconversion rate of antibodies were analyzed before and after vaccination.@*Results@#There were 290 participants in the vaccination group, including 132 men (45.52% ), and 290 controls, including 132 men ( 45.52% ). There were no significant differences between the vaccination group and the control group in terms of the protective rate or GMT of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV prior to vaccination ( P>0.05 ). Following vaccination, the protective rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were 98.62%, 94.14% and 88.28%, and the GMT of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV increased by 9.26, 6.19 and 10.09 folds, while the seroconversion rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were 78.62%, 68.28% and 71.38%, respectively. The protective rates, GMT and seroconversion rates of antibodies against influenza viruses A ( H1N1 and H3N2 ) and BV were all significantly greater in the vaccination group than in the control group post-vaccination ( P<0.05 ). A lower increase was seen in the GMT of antibodies against the influenza virus BV among residents at ages of 80 years and older (increase by 7.91 folds) than among residents at ages of 70 to 79 years ( increase by 12.53 folds ) and 60 to 69 years (increase by 13.32 folds) in the vaccination group post-vaccination ( P<0.05 ), and the seroconversion rate of antibodies against the influenza virus BV was significantly lower in residents at ages of 80 years and older ( 62.57% ) than in those at ages of 70 to 79 years ( 83.33% ) ( P<0.05 ), while the positive conversion rate of antibodies against the influenza virus A ( H3N2 ) was significantly lower in residents at ages of 80 years and older ( 62.57% ) than in those at ages of 60 to 69 years ( 91.30% ) ( P<0.05 ).@*Conclusions@#Low-level immune responses are detected to antibodies against influenza virus A ( H3N2 ) and BV among elderly populations in Jiangbei District of Ningbo City, and trivalent split-virus influenza vaccine shows a high immunogenicity among elder populations. An emphases on improvements in coverage of influenza vaccination among elderly populations at ages of 60 to 69 years, and development of influenza vaccines with a higher protective efficacy for residents at ages of 80 years and older are recommended.
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ObjectiveTo analyze the local human immunodeficiency virus （HIV） infection characteristics and influencing factors of newly reported HIV infected cases and acquired immunodeficiency syndrome patients （AIDS） in Ningbo City from 2017 to 2020， and to provide scientific basis for local effective AIDS prevention and control measures. MethodsFrom January 1， 2017 to December 31， 2020， the newly reported HIV/AIDS patients in Ningbo were recruited and face-to-face questionnaire was used to collect relevant information such as demography， behavior， infection route and infection location of research subjects. The data were processed and analyzed by EpiData 3.1 and SPSS 23.0 software. ResultsA total of 449 newly reported HIV/AIDS patients were recruited and 399 cases completed the survey. The survey subjects were mainly male （346， 86.7%）， unmarried （188， 47.1%），with local household registration （246， 61.6%）， with junior high school and lower education level （195， 48.9%）， and 25 to 44 years old （206， 51.6%）. The local HIV/AIDS infection rate was 68.4% （273/399）， among which the local HIV/AIDS infection rate of homosexual transmission was 74.9% （146/195）. Multivariate analysis showed that heterosexual transmission of HIV infection （OR=0.349，95%CI：0.201‒0.606）， using dating software to find local sexual partners （OR=2.133，95%CI：0.201‒0.606）， and received no AIDS education services before HIV confirmation （OR=1.914，95%CI：1.196‒3.063） were the influencing factors of local HIV/AIDS infection （P<0.05）. ConclusionThe newly reported HIV/AIDS in Ningbo mainly infects HIV locally， and the coverage of HIV/AIDS education is insufficient before HIV confirmation. A high proportion of local HIV/AIDS infections is found in people who find local sexual partners through dating software and who infected through homosexual transmission before HIV confirmation. It is necessary to strengthen local HIV/AIDS education and Internet intervention among MSM who seek sexual partners through dating software.
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Objective:To analyze the risk factors of modified midline catheter-related thrombosis and propose countermeasures.Methods:Retrospective analysis was used to divide patients admitted to the neurology department of Nanjing Drum Tower Hospital from February 2018 to July 2020 into thrombotic group (9 cases) and nonthrombotic group (117 cases). Univariate analysis and binary Logistic regression were used to analyze the risk factors for catheter-related thrombosis.Results:The incidence of thrombosis was 7.14% (9/126) in patients with modified midline catheters. Univariate analysis showed that the occurrence of catheter-related thrombosis in patients was related to the primary type ( χ2 value was 6.331, P<0.05) and catheter pretreatment ( χ2 value was 4.016, P<0.05). Multivariate analysis showed that there was no significant difference between the primary disease type and the catheter pretreatment method ( P>0.05). Conclusions:The incidence of thrombus in patients with encephalitis and pretreated catheter with normal saline is high, preventive care should be taken before the occurrence of thrombus, and thrombolytic therapy should be taken as soon as possible after the occurrence of thrombus.
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Objective:To assess the impact of integrated curriculum (vertically integrated curriculum system) and traditional curriculum system on the perceptions of post competency of undergraduate medical students.Methods:Bibliographic retrieval method and expert consultation were used to compile the questionnaire of perceptions on the post competency of undergraduate medical students. The questionnaire was conducted online to survey the undergraduate medical students from Shanghai Jiao Tong University School of Medicine during March to April, 2019. SPSS 20.0 software was applied for data analysis, chi-square test was used to analyze the classroom teaching forms of medical undergraduates who received different curriculum systems, and their cognition of the doctor post competency and cognitive pathways, and finally the top 10 important competencies were compared.Results:A total of 200 questionnaires were distributed and 167 were recovered, with a recovery rate of 83.5%. Workshop learning was more common in the vertically integrated undergraduate curriculum. Compared with Chinese traditional curriculum, the medical students taught by the vertically integrated undergraduate curriculum were much better informed about competency ( P<0.05). The access to knowledge of competency was also statistically different between two groups of students ( P<0.05). Conclusion:The vertically integrated curriculum is more efficient in helping undergraduate medical students to acquire knowledge about competency.
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Pulmonary fibrosis (PF) is a chronic, progressive, fatal interstitial lung disease with limited available therapeutic strategies. We recently reported that the protein kinase glycogen synthase kinase-3
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Lung cancer is the most frequently diagnosed cancer and the leading cause of cancer-related death. Molecular targeted therapy for lung cancer, especially non-squamous non-small cell lung cancer, has developed rapidly and achieved good results. Several studies have found that fibroblast growth factor receptor (FGFR) signaling supports cancer cell proliferation and stimulates angiogenesis through different mechanisms, which plays a role in the development and progression of several tumors. This indicates that the inhibitions of FGFR signaling pathway may inhibit the proliferation of cancer cells. Dysregulation of FGFR signaling has been observed in some types of malignancy, including lung squamous cell carcinoma (LUSC), making FGFR a potential therapeutic target for LUSC. This review focuses on the role of FGFR signaling and some FGFR inhibitors in LUSC.
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It was generally believed that muscular atrophy of paralyzed limbs after stroke was due to disuse. However, recent studies have found that secondary lesions of motor neurons in the contralateral anterior horn of the spinal cord and the decrease of motor units lead to denervation, which plays an essential role in muscular atrophy and muscle fiber type transition. This article reviews the phenomenon and mechanism of muscular atrophy and denervation of paralyzed limbs after stroke, to provide a reference for clinical evaluation and experimental research.
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OBJECTIVE：To prepare Cheler ythrine （CHE） solid dispe rsion （SD），optimize the formulation technology ， characterize its preparation and investigate its in vitro antioxidant activity. METHODS ：The content of CHE in SD was determined by UV spectrophotometry. Based on single factor tests ，using the product yield as index ，using preparation method ，carrier material type，carrier material proportion （drug-carrier material mass ratio ）as factors ，the formulation technology of SD was optimized by L（9 34）orthogonal test and validated. Based on solubility and accumulative dissolution determination ，the product was characterized with thermal analyssis ，X-ray diffraction and scanning electron microscope. Using ascorbic acid as positive control ，in vitro antioxidant activity of the product was determined by DPPH method. RESULTS ：The linear range of CHE was 2.4-5.6 μg/mL； quantitation limit and detection limit were 0.066 9，0.022 1 μg/mL；RSDs of precision ，stability and reproducibility tests were all lower than 2％；recoveries were 97.50％-99.25％（RSD＜1％， n＝3）. The optimal preparation technology included using PEG 6000 as carrier material ，carrier material ratio of 1 ∶ 3， prepared by solvent method. Three batches of CHE-PEG-SD were prepared. Verification test results showed that the 话：0539-80311889。E-mail：zhenshengao@163.com accumulative dissolution of CHE-PEG-SD was （61.72 ± 0.67）％ at 15 min，and the yield was （99.04±0.83）％. The results of characterization showed that after CHE-PEG-SD prepared ， its solubility （3.725 mg/mL）and accumulative dissolution （61.25％，15 min）were higher than CHE raw material [ 0.098 mg/mL， 6.24％（180 min）]. The endothermic peak and crystal absorption peak moved or even disappeared compared with raw material and the carrier material ，and CHE was uniformly dispersed in the carrier material as an amorphous state. Results of in vitro antioxidation test showed that different concentration of CHE-PEG-SD showed certain ability of DPPH free radical scavenging ，and the IC 50 was 0.124 mg/mL，higher than 0.041 mg/mL of ascorbic acid. CONCLUSIONS ：Established content determination method is simple and accurate. The optimal SD formulation technology is stable and feasible. The solubility of prepared CHE-PEG-SD increases，and the dissolution in vitro increases，showing certain in vitro oxidation resistance.
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Objective To compare the clinical effects and the subjective perception of surgeons with three-dimensional (3D) and two-dimensional (2D) laparoscopic C1 radical hysterectomy surgeries for cervical cancer. Methods The retrospective cohort study was conducted. The clinicopathological data of 101 patients with cervical cancer who received C1 laparoscopic radical hysterectomy (C1-LRH) surgery from June 2015 to August 2017 were collected. Of all patients, 42 cases undergoing 3D laparoscopic surgery and 59 cases undergoing 2D laparoscopic surgery were respectively allocated into the C1-3DLRH group or C1-2DLRH group. The clinical effect and the subjective perception of surgeons were compared between the two groups. Results (1) There was no significant difference between the C1-3DLRH group and C1-2DLRH group in terms of age, body mass index (BMI), International Federation of Gynecology and Obstetrics (FIGO) stage, pathologic type, etc. (all P>0.05). Compared with C1-2DLRH group, the operation time was significantly shortened [(192±54) vs (221±54) minutes, P<0.01], blood loss was significantly less [(102±88) vs (167 ± 117) ml, P<0.01], and the success rate of inferior hypogastric plexus (IHP) bladder branch preservation was significantly increased [86% (36/42) vs 66% (39/59), P<0.05] in C1-3DLRH group. There were no significant difference in the number of lymph nodes, the incidence of operative complications, the infection rate, the time of catheterization and the length of hospitalization between the two groups (all P>0.05). The long-term bladder function was evaluated at the twelfth month after operation, 39 patients in the C1-3DLRH group and 53 patients in the C1-2DLRH group were completed the survey. The results showed that 13% (5/39) of the patients in the C1-3DLRH group had long-term bladder dysfunction, which was lower than that 21% (11/53) of the C1-2DLRH group, but there was no significant difference between the two groups (χ2=0.980, P=0.322). (2) A total of 251 laparoscopic surgeons questionnaires were eligible. The incidence of side effects in the first and second generation of 3D and 2D laparoscopic surgeons was 20.4% (10/49), 6.9% (6/87) and 3.5% (4/115), respectively. The incidence of side effects in the first generation of 3D laparoscopic surgeons was higher than that in the second generation of 3D (χ2=5.463, P=0.019) and 2D laparoscopic surgeons (χ2=12.475, P<0.01). There was no difference between the second generation of 3D and 2D laparoscopic surgeons (χ2=1.208, P=0.272). Conclusions 3D laparoscopy is advantageous to the preservation of autonomic nerve in C1-LRH operation and may improve the quality of operation compared with 2D laparoscopy. The second generation of 3D laparoscopic device might overcome the side effects of the surgeons.
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Objective@#To investigate the color stability of computer aided design and computer aided manufacture (CAD/CAM) composite ceramic/resin cements after accelerated ageing.@*Methods@#Twelve groups (ten samples each group) were used as experimental groups, which were composed of CAD/CAM composite ceramic of three kinds of thickness (0.50, 0.75, 1.00 mm) (Lava Ultimate) associated with resin cements (Variolink N) of four colors (A1, A3, T, BL1). Another three groups of CAD/CAM composite ceramic/resin cements of three different kinds of thickness (0.50, 0.75, 1.00 mm) were used as control groups (ten samples each group). All samples were put into the xenon lamp ageing instrument to implement accelerated ageing. Spectrophotometers were used to measure the lightness (L*), red green color value (a*) and blue yellow color value (b*) of all samples before and after accelerated ageing process, and the changes of color variation (ΔE) was calculated. The effect of composite ceramic thickness and resin cement color on the changes of color variation (ΔE) before and after the ageing of CAD/CAM composite ceramic/resin cement and whether there was an interaction between them were tested by two-way ANOVA.@*Results@#Before and after accelerated ageing, the ΔE of CAD/CAM composite ceramic/resin cements were <3.3. Two-way ANOVA showed that the thickness of CAD/CAM composite ceramics had an effect on ΔE (F=27.025, P<0.001), and the color of resin cement also had an effect on ΔE (F=15.606, P<0.001), but there was no interaction between them (F=0.534, P=0.829).@*Conclusions@#The thickness of CAD/CAM composite ceramics and the color of resin cements could both affect the color stability of composite ceramic/resin cements combination. However, the resulted color change is within the clinically acceptable range.
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Objective To analyze the prognosis ofⅠb2 andⅡa2 cervical squamous cancer without high risk factors treated with neo-adjuvant chemotherapy(NACT)and radical hysterectomy. Methods This retrospective study included patients with International Federation of Gynecology and Obstetrics (FIGO)stageⅠb2 andⅡa2 cervical squamous cancer without high risk factors who underwent platinum-based NACT followed by radical surgery from January 2008 to January 2015.The responses of NACT were observed and compared in their effect on postoperative pathologic risk factors. Kaplan-Meier method and Cox regression analysis were performed to analyze survival status. Results This study was recruited 282 patients with the average age of(44.4±6.7)years old.After NACT,42 patients achieved complete response [CR,14.9%(42/282)],while 138 patients achieved partial response[PR,48.9%(138/282)]and 102 stable disease [SD, 36.2%(102/282)]. The rate of pathologic diameter ≥4 cm, deep stromal invasion(DSI) positive and lymph-vascular space invasion(LVSI)positive rate decreased significantly in CR and PR group compared with SD group(P<0.05). The number of postoperative risk factors in CR, PR and SD groups varied significantly(χ 2=64.869, P=0.000). Besides,the rate of multiple intermediate risk factors was respectively 0 vs 13.8% vs 45.1%(χ2=7.107, P=0.008). The disease relapsed in 23 patients, and 12 died. On the whole series, 5-year overall survival rate was 91.7%, and 5-year recurrence-free survival rate was 88.9%. The rate of recurrence(P=0.002)and mortality(P=0.036)were higher in LVSI positive patients compared with LVSI negative. And the rate of recurrence was higher in patients with multiple intermediate risk factors,compared with no or one intermediate risk factors(P=0.002).Univariate analysis revealed that LVSI positive and multiple intermediate risk factors were the factors predicted recurrence and mortality(P<0.05), and no significance in age, stage, tumor grade, tumor diameter before or after NACT, response to NACT,or DSI positive factors(all P>0.05).The multivariate analysis showed that,the factor of primary tumor diameter≥6 cm(P=0.022)and multiple intermediate risk factors(P=0.001)were independent prognostic variables for recurrent-free survival.Besides,multiple intermediate risk factors was independent prognostic variable for overall survival(P=0.034). After surgery, 107 patients did not receive adjuvant therapy,while 175 patients received adjuvant therapy with 26 radiotherapy,46 chemotherapy and 103 concurrent radiochemotherapy.On survival analysis of postoperative adjuvant treatment,5-year recurrence-free survival rate of radiotherapy group was significantly lower in patients with the factor of SD response to NACT(P=0.011)and multiple intermediate risk factors(P=0.008), while overall no significance in overall survival rate(P>0.05).Conclusions NACT may be play beneficial role in relieving the status of intermediate risk factors for stage Ⅰb2 andⅡa2 cervical squamous cancer without high risk factors. The status of multiple intermediate risk factors is independent prognostic factors for recurrence and mortality. For patients with multiple intermediate risk factors, postoperative adjuvant chemotherapy or concurrent radiochemotherapy might be the better choice to prevent relapse.
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Vitamin D has been found to produce therapeutic effects on obesity-associated insulin resistance and dyslipidemia through its potent anti-inflammatory activity, but the precise immunomodulatory mechanism remains poorly understood. In the present study we found that 1,25-dihydroxyvitamin D [1,25(OH)D], the biologically active form of vitamin D, significantly attenuated monosodium glutamate (MSG)-induced obesity and insulin resistance as indicated by body weight reduction, oral glucose tolerance improvement, and a glucose infusion rate increase as detected with hyperinsulinemic-euglycemic clamp. Moreover, 1,25(OH)D not only restored pancreatic islet functions but also improved lipid metabolism in insulin-targeted tissues. The protective effects of 1,25(OH)D on glycolipid metabolism were attributed to its ability to inhibit an obesity-activated inflammatory response in insulin secretory and targeted tissues, as indicated by reduced infiltration of macrophages in pancreas islets and adipose tissue while enhancing the expression of in liver tissue, which was accompanied by increased infiltration of Treg cells in immune organs such as spleen and lymph node as well as in insulin-targeted tissues such as liver, adipose, and muscle. Together, our findings suggest that 1,25(OH)D serves as a beneficial immunomodulator for the prevention and treatment of obesity or metabolic syndrome through its anti-inflammatory effects.
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Background Pars plana vitrectomy (PPV) is the main therapy for advanced stage of proliferative diabetic retinopathy (PDR).Intravitreal injection of anti-vascular endothelial growth factor(VEGF) drug before PPV for PDR has been proved to decrease the occurrence of postoperative complications.However,the effect of conbercept on PPV was rarely reported.Objective This study was to observe the efficacy of intravitreal injection of conbercept (IVC) on PPV for PDR.Methods A nonrandomized control clinical trial was performed.A total of 47 PDR patients (51 eyes) undergoing PPV were enrolled in Yuebei People's Hospital from June 2015 to May 2016.All subjects were divided into IVC group (24 patients,26 eyes) and control group (23 patients,25 eyes).The incidence of iatrogenic retinal hole,rate of using intraocular tamponade,incidence of postoperative complications,central retinal thickness (CRT) and the best corrected visual acuity (BCVA) were comparatively analyzed.Results The incidence of iatrogenic retinal hole in IVC group was 7.69％,lower than 32.00％ in the control group,the difference was statistically significant (P=0.038).The percentage of using intraocular tamponade in IVC group was 19.23％,lower than 52.00％ in the control group,the difference was statistically significant (x2 =5.993,P =0.014).Four months after surgery,the incidence of postoperative vitreous re-hemorrhage in IVC group was significantly lower than that in the control group,the difference was statistically significant (P =0.024).Three months after surgery,the CRT in IVC group was (278.04 ± 43.46) μm,which is thinner than (340.76 ± 84.91) μm in the control group,the difference was statistically significant (t =-3.340,P =0.002).Three months after surgery,the BCVA in IVC group was better than that in control group,with significant difference between the two groups (Z =-2.114,P=0.034).No adverse effect was observed after IVC.Conclusions IVC before PPV for PDR can reduce the incidence of iatrogenic retinal hole and the rate of using intraocular tamponade,decrease the incidence of postoperative complications and macular retinal thickness,and improve the visual acuity.