Objective:To analyse viable Enterococcus faecalis(E.faecalis)in root-well-filled teeth associated with failed endodontic treatment by using propidium monoazide (PMA)in combination with real time qPCR.Methods:Bacterial samples were extracted from 34 root-canal-treated teeth with post-treatment apical periodontitis.Each sample was separated into 2 different tubes.PMA was added to one of the tubes,and the other was left untreated.Then,DNA extraction and qPCR were performed.Results:E.faecalis was found in 20 of the 34 samples(58.8%).In PMA treated and none-treaten samples the Ct value of E.faecalis was 25.1 2 ±2.04 and 24.62 ± 2.02 respectively(P =0.001 ).Conclusion:PMA may be feasible in differentiating viable and dead Enterococcus faecalis cells.

Objective: To investigate the prevalence and influencing factors of chronic diseases among cured leprosy patients in Huai'an City, so as to provide insights into chronic diseases control among cured leprosy patients. Methods: All cured leprosy patients in Huai'an City in 2021 were enrolled from the National Leprosy Management Information System in China. The demographic data, family status, leprosy diagnosis and treatment, health status and development of chronic diseases were collected using face-to-face questionnaire surveys and physical examinations, and the factors affecting the development of chronic diseases were identified among cured leprosy patients using a multivariable logistic regression model. Results: Totally 708 cured leprosy patients were included, with a male to female ratio of 2.75︰1, and a mean age of (71.84±10.09) years. The overall prevalence of disability was 48.45%. The prevalence of chronic diseases was 31.78% among participants, and the prevalence rates of hypertension, diabetes, coronary heart disease, stroke, dyslipidemia, tumor, chronic obstructive pulmonary diseases were 25.14%, 4.10%, 3.67%, 3.67%, 2.26%, 2.26% and 0.85%, respectively. There were 154 participants with a type of chronic diseases (21.75%), 61 with two types of chronic diseases (8.62%) and 10 with 3 and more types of chronic diseases (1.41%). Multivariable logistic regression analysis identified complete loss of labor ability (OR=1.484, 95%CI: 1.015-2.171), labor income as the major economic source (OR=0.621, 95%CI: 0.407-0.948), being cared of (OR=1.832, 95%CI: 1.203-2.788) and disability (OR=1.715, 95%CI: 1.127-2.608) as factors affecting the development of chronic diseases among cured leprosy patients. Conclusions There is a high risk of chronic diseases among cured leprosy patients with loss of labor ability, with government subsidy and others' funding as the major economic source, requiring to be cared of and with disability in Huai'an City.

Objective To discuss the MRI findings of common complications following hip arthroplasty and their association with operative and pathological findings to improve the early diagnosis and etiological differential diagnosis for common complications following hip arthroplasty. Methods Forty-six patients with hip arthroplasty complication were included in this study. We observed prosthesis location, signal changes between prosthesis and bone, and periprosthesis signal changes, signal changes of articular capsule, adjacent soft tissue and bone on MR images. Diagnostic value of MRI in detecting hip arthroplasty complication was evaluated with operative and pathological findings as reference standard. Results Complications following hip arthroplasty included aseptic loosening (n=26), osteolysis (n=12), infection (n=12), heterotopic ossification (n=4), pseudoneoplasm (n=4) and periarthroplasty fracture (n=1). The MRI finding suggestive of aseptic loosening in 24 cases was a smooth intermediate signal intensity layer along the interface. Osteolysis is seen as soft tissue signal intensity material replacing normal high signal intensity fatty marrow in 12 cases. Bone marrow edema, bone destruction, fluid collection, estracapsular collections, periprosthetic muscle edema, and sinus were predictors of infection. On MRI, mature heterotopic ossification had the appearance of cancellous bone in 5 cases. Pseudoneoplasm represents fluid signal intensity with intermediate signal intensity pseudocapsule in 5 cases. Periprosthetic fracture included hypointesense fracture lines, periosteal reaction, and periprosthetic muscle edema in one patient. Conclusion MRI is useful in detecting osseous and soft-tissue abnormalities in patients with hip implants.

Objective To investigate the expression of Notch1,Delta-like ligand 4 (DLL4),hairy and enhancer of split-1 (HES-1),microvessel density (MVD),lymphatic vessel density (MLD) in gastric carcinoma,so as to discuss their roles in the development of gastric carcinoma.Methods Gastric carcinoma,paracancer tissues which was apart from the edge of cancer tissue ＞ 60 mm obtained during operation and normal gastric mucosa obtained during gastroscopy were used as controls.All specimens were made tissue microarray.The expressions of Notchl,DLL4,HES-1 were detected by immunohistochemistry.Immunohistochenical double taining was used to detect MVD and MLD.The relationships between Notch1,DLL4,HES-1 expression and angiogenesis,lymphangiogenesis and their significances were analyzed.Results The positive rate of Notch1 in gastric carcinoma was 48.30％,significantly higher than that of paracancerous (25.00％,x2 =6.38,P ＜ 0.05) and control group (16.67％,x2 =10.18,P ＜0.05).The differences of the positive rate of DLL4 in gastric carcinoma (55.94％),paracancerous (45.70％) and control group (56.67％) were not significant (x2 =1.18,P ＞0.05 ; x2 =0.005,P ＞ 0.05).The differences of the positive rate of HES-1 in gastric carcinoma (36.64％),paracancerous (34.40％) and control group (33.33％) were not significant (x2 =0.05,P ＞ 0.05 ;,x2 =0.11,P ＞ 0.05).The mean of MVD in gastric carcinoma group was 28.84 ± 14.17,which was significantly higher than that in paracancerous group (17.02 ±8.54,t =4.03,P＜0.05) and control group (16.69 ±7.21,t =5.01,P＜0.05).The mean of MLD in gastric carcinoma group was 8.55 ±4.98,which was significantly higher than that in paracancerous group (4.05 ± 2.48,t =9.30,P ＜ 0.05) and control group (3.99 ± 1.56,t =10.32,P ＜ 0.05).The expression of DLL4 was correlated with MVD (t =2.77,P ＜ 0.05),but wasn't correlated with MLD (t =1.89,P ＞0.05).There were no correlations between the expression of Notch1,HES-1 and tissues MVD,MLD (P ＞0.05).Conclusion Notch1 plays important roles in the development of gastric carcinoma.There are many angiogenesis and lymphangiogenesis in gastric carcinoma.The expression of DLL4 in gastric carcinoma has certain effect in the formation of microvessel.

Objective To investigate changes of the interhemispheric coordination integrity in patients with hemi-parkinsonism using resting-state functional magnetic resonance imaging(rs-fMRI) homotopy technique called voxel-mirrored homotopic connectivity(VMHC).Methods Sixteen Parkinson disease(PD) patients with right body side motor symptom onset(RPD),15 patients with left side onset(LPD),and 19 age-,gender-,and education-matched healthy controls(HC) were included in this study.rs-fMRI scanning and pre-processed the raw data were performed.Then by using analysis of variance(ANOVA) and two sample t tset,we performed VMHC analyses on rs-fMRI data of these participants(P＜0.05,corrected with AlphaSim,clusters≥16 voxels).Exploratory linear correlations analyses were performed between the VMHC of regions showing significant group differences and the clinical features of LPD or RPD patients.Results Compared with HCs,patients with LPD had significantly reduced VMHC in visual regions,sensorimotor regions,and the cerebellar cortex(voxels size of 17-77,t=-5.06--3.42,P＜0.05).Patients with RPD exhibited decreased VMHC in the prefrontal cortex and sensorimotor regions.Both LPD and RPD groups had increased VMHC in subcortical regions.When compared with the RPD group,the LPD group displayed decreased VMHC in the visual regions,sensorimotor regions(voxels=16 and 18; t=-3.68and-3.87,respectively,both P＜0.05) and increased VMHC in the supramarginal gyrus(voxels=4,t=4.72,P＜0.05);ROI-based correlation analyses indicated that the VMHC in the inferior occipital gyrus and the postcentral gyrus was negatively correlated with the BDI-Ⅱ scores in the LPD group(r=-0.58 and-0.59,respectively; both P＜0.05),and positively correlated with the MMSE scores(r=0.56 and 0.52,respectively;both P＜0.05).In the RPD group,a positive correlation was found for the VMHC in the supramarginal gyrus and the illness duration(r=0.56,P＜0.05) and for the VMHC in the postcentral gyrus and the(mini-mental state exam) MMSE(r=0.53,P＜0.05).Conclusions The differential pattern of deficits in the interhemispheric coordination integrity in hemi-parkinsonism reflected by VMHC may provide insights into the neurological pathophysiology underlying the asymmetry of symptom appearance in PD.

This study was aimed to analyze the pathogen distribution,drug resistance and traditional Chinese medicine (TCM) syndrome of patients with primary nephrotic syndrome complicated with pulmonary infection for the guidance of clinical practice.The clinical data of 180 patients with primary nephrotic syndrome complicated with pulmonary infection were analyzed.The results showed that among 180 patients,117 were male,accounting for 65％;73.33％ of them were over 40 years old.Membranous nephropathy was the most common pathological type,accounting for 40％.Gram-negative bacteria were the main pathogen,accounting for 51.72％.The drug resistance rates of piperacillin/tazobactam,imipenem,amikacin,gentamicin were the lowest.The drug resistance rates of third generation of cephalosporins and quinolone antibiotics were in the middle.In TCM syndrome differentiation,central qi deficiency and phlegm syndrome occupied the highest proportion,accounting for 25.56％;and the phlegm heat in the lung syndrome,accounting for 17.78％;wind evil attacking the lung syndrome,accounting for 13.33％;qi deficiency and phlegm syndrome,accounting for 9.45％;qi deficiency,blood stasis and water stagnation syndrome,accounting for 8.89％;the mixture of deficiency and excess syndrome,accounting for 59.45％,with qi deficiency as the main part.It was concluded that middle-aged and older men,pathologic type of membranous nephropathy had the higher rate of suffering pulmonary infection.Gram-negative bacteria were the main pathogen.The choice of antibiotics should be based on piperacillin/tazobactam,and third generation of cephalosporins.Qi deficiency and phlegm syndrome was the most common TCM syndrome.

Objective To explore significance of alpha‐fetoprotein isoform L2(AFP‐L2) in the screening of Down syndrome in pregnant women ,so as to provide references for clinical application .Methods A total of 250 healthy pregnant women and 22 preg‐nant women with Down syndrome were enrolled in this study .Serum specimens were collected and AFP‐12 was separated and cap‐tured by using the magnetic bal ,time‐resolved fluorescence immunoassay was used to detect levels of AFP and AFP‐L2 ,and the percentage of AFP‐L2 (AFP‐L2% ) was calculated .Results The serum level of AFP of pregnant women with Down syndrome [(20.2±4.2)ng/mL]was lower than that of healthy pregnant women[(46.7±19.9)ng/mL],and had statistically significant difference(P<0 .05) .Serum AFP‐L2% of pregnant women with Down syndrome was higher than that of healthy pregnant women , and had statistically significant difference(P<0 .05) .Conclusion Detection of AFP level and AFP‐L2% could be an indicator for Dow n syndrome screening .

OBJECTIVETo investigate long-term efficacy and safety of ambrisentan monotherapy in patients with pulmonary arterial hypertension (PAH).

METHODSPatients with PAH who received 2.5 mg or 5 mg of ambrisentan once daily between July 10, 2011 and August 30, 2012 for at least 6 months were enrolled. The efficacy endpoints were change in exercise capacity, World Health Organization (WHO) functional class and N-terminal pro-brain natriuretic peptide (NT-proBNP) level, echocardiographic parameters. The safety endpoint was the safety of long-term ambrisentan administration, as defined by the incidence and severity of adverse events.

RESULTSA total of 18 patients with PAH were enrolled. Mean age was (39 ± 17) years, 8 (55.6%) were female, and 11 (61.1%) patients were in WHO functional class III. The median duration of treatment was 17 months (range: 6-26 months). After treatment, the 6MWD was significantly increased[ (495 ± 97) m vs. (400 ± 91) m, P < 0.001], NT-proBNP was significantly reduced [308 (53-1 645) ng/L vs. 80(22-454) ng/L, P = 0.005], the systolic pulmonary artery was significantly decreased [(62 ± 30) mmHg vs. (82 ± 41) mmHg, P = 0.001] and left ventricular end diastolic diameter was significantly increased [(44 ± 6) mm vs. (40 ± 6) mm, P < 0.004] compared to pre-treatment. WHO functional class was improved compared with baseline in 11(61.1%) patients, stable in 7(38.9%) patients. No patient died during the treatment period. No patient was withdrawn from this study for safety reasons.

CONCLUSIONSLong-term treatment of ambrisentan can effectively improve the exercise capacity, reduce systolic pulmonary artery pressure and NT-proBNP in PAH patients. Ambrisentan is safe and well tolerated in Chinese PAH patients.

Adult ; Blood Pressure ; Female ; Humans ; Hypertension, Pulmonary ; drug therapy ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; metabolism ; Peptide Fragments ; metabolism ; Phenylpropionates ; therapeutic use ; Pyridazines ; therapeutic use ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the efficacy and safety of inhaled iloprost on top of other pulmonary hypertension (PH) specific therapies for patients with PH and severe right heart failure.

METHODSWe consecutively enrolled WHO functional class IV patients with PH and chronic thromboembolic pulmonary hypertension (CTEPH) in Shanghai Pulmonary Hospital from January 2011 to January 2013. Inhaled iloprost was administrated to all enrolled patients, oral endothelin antagonist receptors (ERAs) and/or type 5 phosphodiasterase inhibitors (PDE5-I) were also used as basis therapies. The in-hospital outcomes and the changes of right heart functional parameters were observed.

RESULTSTwenty-four patients with PH and 5 patients with CTEPH were enrolled. After a mean treatment duration of (23 ± 13) days, 3 patients dead and significant improvement was observed in the remaining 26 patients. Compared with the baseline, heart rate decreased from (99 ± 14) to (91 ± 12) bpm (P = 0.001), plasma NT-proBNP level decreased from 5 823 (3 029-13 248) to 3 220 (1 678-6 720) ng/L (P < 0.001), tricuspid annular plane systolic excursion (TAPSE) increased from (1.3 ± 0.4) to (1.4 ± 0.3) cm (P = 0.018), right ventricular diameter decreased (left-to-right diameter from (57 ± 11) to (53 ± 10) mm, P = 0.040, and superoinferior diameter from (69 ± 11) to (64 ± 16) mm, P = 0.027), Tbil also decreased from (41 ± 34) to (26 ± 17) µmol/L (P < 0.001). No severe side effects were observed.

CONCLUSIONThe strategy of inhaled iloprost on top of other PAH-specific target therapy medications is effective and safe for PH patients with severe right heart failure.

Heart Failure ; Humans ; Hypertension, Pulmonary ; Iloprost ; Natriuretic Peptide, Brain ; Peptide Fragments ; Vasodilator Agents ; Ventricular Dysfunction, Right

Objective: To investigate the distribution and proportion of M1/M2 macrophages in the periodontal tissues of rats with and without periodontitis. Method: Twelve Sprague-Dawley rats were randomly divided into a chronic periodontitis group (CP, n = 6) and a periodontal health group (PH, n = 6). The periodontitis model was induced at the first mandibular molar using a stainless steel ligature and was confirmed by histological analysis. M1 macrophages were labeled with inducible nitric oxide synthase (iNOS), and M2 macrophages were labeled with CD163. The distributions of M1 and M2 macrophages in the two groups were determined via immunohistochemistry and immunofluorescence, and the M1/M2 ratios were compared between the two groups. Results : The M1 type macrophage count in the PH group was 12.17 ± 1.40, and the M1 macrophage count in the CP group was 40.00 ± 3.20; there was a statistically significant difference between the two groups (t = 7.96, P＜0.0001). The M2 macrophage count in the PH group was 4.50 ± 1.09, and the M2 type macrophage count in the CP group was 5.33 ± 0.67. There was no statistically significant difference between the two groups (t = 0.65, P = 0.53). The M1/M2 ratio in the CP group was 3.72 ± 1.08, and the M1/M2 ratio in the PH group was 8.31 ± 1.37; there was a statistically significant difference between the two groups (t = 2.63, P= 0.025). Conclusion During periodontitis, M1 macrophages increased significantly and were widely distributed; they may be involved in the progression of periodontitis and may be closely related to the destruction of the cementum.