Objective To explore the effect of Morinda citrifolia juice(MCJ)combined with ethylene diamine tet-raacetic acid(EDTA)on premolar bonding strength and nanoleakage and compare the results with those of the most commonly used root canal irrigation solution,sodium hypochlorite(NaClO),to provide a reference for clinical applica-tion.Methods This study was approved by the ethics review committee.Sixty-three human premolars extracted for orthodontic treatment were randomly divided into a control group(distilled water group)and 6 experimental groups ac-cording to the different rinsing solutions used after the surface enamel was removed.The experimental groups included Group A(2.5%NaClO),Group B(5.25%NaClO),Group C(6%MCJ),Group D(2.5%NaClO-17%EDTA),Group E(5.25%NaClO-17%EDTA),and Group F(6%MCJ-17%EDTA)(n = 9).After soaking in the corresponding rinsing so-lution for 20 minutes,they were layered and stacked on their surfaces to form 4 mm×4 mm×3 mm Z350 resin blocks.Six samples from each group were cut into 1 mm×1 mm×8 mm specimen strips for microtensile bonding strength test-ing.The fracture type was determined under a stereomicroscope,and the remaining 3 samples from each group were aged and cut into 1 mm thick slices for interface nanoleakage testing and scanning electron microscopy observation of the resin dentin bonding interface.Results There were significant differences in the microtensile bonding strength among the groups(P＜0.05),and the control group had the highest bonding strength.Among experimental groups,Group B had the lowest bonding strength,mainly bonding interface fracture,and Group F had the highest bonding strength,mainly mixed fracture.There were significant differences in nanoleakage among all groups(P＜0.05),and the control group had the lowest nanoleakage value.Among experimental groups,Group B had the highest nanoleakage,with resin protrusions being unaltered,and Group F had the lowest nanoleakage value,with resin protrusions being thick and dense.Conclusion The higher the concentration of NaClO was,the worse the bonding strength and edge sealing of the crown dentin were.The effects of root canal irrigation with MCJ and EDTA on the adhesive strength and edge sealing of crown dentin were less pronounced than those of root canal irrigation with NaClO and EDTA.

OBJECTIVE To prepare Lanqin extract/cyclodextrin complexes for probing its effects of different kinds of cyclodextrins on the taste-masking. METHODS Bitter compounds in the extracts were performed on ion exchange resin adsorption combined with HPLC. The formulations of complexes were screened by human taste panel method. The complexes were prepared by spray-drying and characterized through scanning electron microscope, differential scanning calorimetry, and hygroscopicty test. Moreover, the in vitro bitter taste perception of complexes was evaluated by electronic tongue and further valuation the credibility of the results was conducted on human gustatory sensation tests. RESULTS The sulfobutylether-β-cyclodextrin-based combinational formulation with multiple cyclodextrins could significantly inhibit the bitter taste of the extract which mainly caused by its alkaline constituents at a lower dosage. The results of electron scanning microscopy, differential scanning calorimetry, and hygroscopicity indicated that the Lanqin extract and cyclodextrin in the complex may form inclusion complexes rather than physical mixtures. The results of electronic tongue and human gustatory sensation tests showed that, compared with the extract suggested the taste characteristics of the optimal complexes was similar to corresponding excipient while the bitterness significantly reduced. CONCLUSION The Lanqin extract/cyclodextrin complexes prepared in this study are suitable for industrial production for its good flavour, less total amount of cyclodextrins, and simple process. The present study has important significance for the development of related taste masking products of Lanqin.

Objective:To systematically review and integrate the caring experience of caregivers of lung transplant patients.Methods:Qualitative studies on the caregiving experience of caregivers of lung transplant patients were searched by computer from PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure and Wanfang data, and the search period was from establishment of the databases to April 30, 2023. The qualitative research quality evaluation criteria (2016 edition) of the Joanna Briggs Institute Evidence Based Health Care Center in Australia were used to evaluate the quality of the included literature, and the Meta-synthesis was used to integrate the literature results.Results:A total of ten articles were included, and 33 clear research results were extracted, which were summarized into eight new categories, and finally summarized into four integrated results, such as heavy burden experience, strong demand, positive experience and satisfaction with the medical service system.Conclusions:Medical workers should attach importance to and pay attention to the burden and needs of caregivers of lung transplant patients, provide professional and emotional support to caregivers, improve their caring ability and quality, and ultimately improve the quality of life of lung transplant patients.

Objective To observe the relationship between functional connectivity(FC)of frontoparietal network(FPN)and cognitive function in patients with cerebral small vessel disease(CSVD)using resting-state functional MRI(rs-fMRI).Methods rs-fMRI of 50 CSVD patients with cognitive impairment(CI group),65 CSVD patients with normal cognition(NC group)and 60 healthy controls(HC group),as well as outcomes of neuropsychological tests were retrospectively analyzed.Brain regions with different FC of FPN were compared among 3 groups and between each 2 groups.Partial correlation analysis was used to evaluate the correlations of FC of brain regions value being statistically different between CI and NC groups and cognitive scores.Results Significant differences of FC in bilateral cingulate gyrus,left middle frontal gyrus,right supramarginal gyrus,right inferior parietal lobule and right medial superior frontal gyrus were found among groups(FWE correction,all P＜0.05).Compared with NC group,FC of left cingulate gyrus decreased,of right inferior frontal gyrus and right medial superior frontal gyrus increased in CI group(FWE correction,all P＜0.05).The decreased FC value of left cingulate gyrus was negatively correlated with clock drawing test score in CSVD patients(r=-0.159,P=0.049).Conclusion CSVD patients with or without CI had extensive abnormal FC of FPN,and the left cingulate gyrus was associated with patient's cognitive function.

Objective:To investigate the changes in gray matter volume of the subsystems as well as intra-subsystem and inter-subsystem functional connectivity in the default mode network (DMN) of relapsing-remitting multiple sclerosis (RRMS) patients with preserved cognitive function.Methods:In this prospective study, thirty-seven RRMS patients with preserved cognitive function who were admitted to Huashan Hospital of Fudan University from April 2020 to January 2021 (RRMS group) and 43 healthy volunteers (HC group) were recruited. Patients in the RRMS group received the cognitive assessment using a clinical cognitive functioning scale. Three-dimensional T 1WI and resting-state functional MRI were performed to obtain the brain structural and functional data. The DMN was divided into three subsystems: CORE, dorsal medial prefrontal cortex (DMPFC), and medial temporal lobe (MTL). The gray matter volume of the three subsystems were extracted from the gray matter volume map generated by spatial normalization; 24 regions of interest (ROIs) of the DMN were defined based on Yeo′s 17 networks, and their functional connectivity values were calculated to derive the mean intra-subsystem and inter-subsystem functional connectivity values. Differences in gray matter volume and functional connectivity between the RRMS and HC groups were compared using independent sample t-tests; Spearman′s partial correlation was used to analyze the correlation between subsystems′ gray matter volume and functional connectivity, as well as between subsystems′ functional connectivity and clinical scale scores. Results:Compared to the HC group, the gray matter volume of the three subsystems of the DMN were considerably reduced in the RRMS group ( P<0.05). The functional connectivity within and between the three subsystems were not statistically significantly different between the HC and RRMS groups ( P>0.05). Based on the ROI analysis, patients with RRMS the brain regions with significantly reduced DMN intra-subsystem functional connectivity values were mainly located in the left dorsomedial prefrontal cortex of the DMPFC, the right lateral temporal cortex of the DMPFC, and the left medial temporal cortex of the MTL, as compared with the HC group ( P<0.01). The gray matter volume of DMPFC was positively correlated with the functional connectivity within DMPFC in the control group ( r=0.326, P=0.040). In the RRMS group, the gray matter volume of CORE was positively correlated with the functional connectivity between CORE and DMPFC ( r=0.363, P=0.038), and the functional connectivity within CORE was positively correlated with scores on the memory and executive screening scale ( r=0.430, P=0.036). Conclusions:RRMS patients with preserved cognitive function exhibit gray matter atrophy in all three DMN subsystems. There is no correlation between the structure and function of the DMPFC subsystem. The functional connectivity within CORE subsystem may reflect memory and execution status; DMPFC and CORE may be critical encephalic regions for neurodegeneration and brain functional changes in RRMS patients with preserved cognitive function.

Objective:To investigate the efficacy of a machine learning model based on radiomics of brain lesions on T 2WI in differentiating multiple sclerosis (MS) from neuromyelitis optica spectrum disorders (NMOSD). Methods:Totally 223 MS and NMOSD patients who were treated from January 2009 to September 2018 in Beijing Tiantan Hospital Affiliated to Capital Medical University, Donghu Branch of the First Affiliated Hospital of Nanchang University, Tianjin Medical University General Hospital, and Xuanwu Hospital of Capital Medical University were analyzed retrospectively, and according to the proportion of 7∶3, 223 patients were completely randomly divided into training set (156 cases) and test set (67 cases). A total of 74 patients with MS and NMOSD who were treated in Huashan Hospital Affiliated to Fudan University and China-Japan Friendship Hospital of Jilin University from January 2009 to September 2018 and in Xianghu Branch of the First Affiliated Hospital of Nanchang University from March 2020 to September 2021 were collected as an independent external validation set. All patients underwent brain cross-sectional MR T 2WI, radiomics features were extracted from T 2WI, and features were selected by max-relevance and min-redundancy and least absolute shrinkage and selection operator algorithms. Then various machine learning classifier models (logistic regression, decision tree, AdaBoost, random forest or support vector machine) were constructed to differentiate MS from NMOSD. The area under curve (AUC) of receiver operating characteristics was used to evaluate the performance of each classifier model in the training set, test set and external validation set. Results:Based on multi-center T 2WI, a total of 11 radiomics features related to the discrimination between MS and NMOSD were extracted and classifier models were constructed. Among them, the random forest model had the best efficiency in distinguishing MS from NMOSD, and its AUC values for distinguishing MS from NMOSD in the training set, test set and external validation set were 1.000, 0.944 and 0.902, with specificity of 100%, 76.9% and 86.0%, and sensitivity of 100%, 92.1% and 79.7%, respectively. Conclusion:The random forest model based on the radiomic features of T 2WI of brain lesions can effectively distinguish MS from NMOSD.

Objective:To study the characteristics and related factors of neonatal intestinal necrosis caused by midgut volvulus.Methods:We retrospectively analyzed the clinical data of neonates with midgut volvulus who were admitted to Guangzhou Women and Children's Medical Center, from January 2009 to December 2019 and confirmed by surgery. The cases with intestinal necrosis belong to the intestinal necrosis group, and those without intestinal necrosis, the non-intestinal necrosis group which was randomly sampled at a ratio of about 4∶1 to the number of cases in the intestinal necrosis group. The two groups were compared in terms of personal history, age of onset, initial symptoms, vital signs within 2 h after admission, time from symptom onset to operation, clinical outcome, laboratory indicators within 2 h after admission, etc. Multivariate Logistic regression analysis was used to screen the related factors of intestinal necrosis in midgut volvulus. The effective warning indexes are screened by receiver operating characteristic (ROC) curve.Results:(1) Among 231 cases of midgut volvulus, 21 cases (9.1%, 21/231) had intestinal necrosis at the time of operation, 87 cases were included in the non-intestinal necrosis group. (2) The levels of heart rate within 2 h after admission, mean arterial pressure, WBC, C reactive protein (CRP), blood glucose and potassium in intestinal necrosis group were significantly higher than those in non-intestinal necrosis group ( P<0.05). Admission days of age, hemoglobin, serum albumin, serum sodium, pH and BE levels were significantly lower than those in the group without intestinal necrosis ( P<0.05). (3) In the multivariate analysis, increased heart rate, mean arterial pressure, serum CRP, and decreased serum sodium, serum albumin, and pH levels were predictors related to intestinal necrosis in patients with midgut volvulus. (4) The area under the ROC curve (AUC) of CRP was 0.883, the cutoff value was 9.88 mg/L, the sensitivity was 76.2%, and the specificity was 94.3%. The ROC curve of serum albumin was 0.792, the cut-off value was 36.65 g/L, the sensitivity was 70.1%, and the specificity was 94.3%. Conclusions:Heart rate, mean arterial pressure, increased CRP, decreased serum sodium, serum albumin and pH are helpful to predict whether intestinal necrosis occurs in midgut volvulus, and CRP > 9.88 mg/L and serum albumin < 36.65 g/L are likely warning indicators.

Objective:To explore the independent risk factors of poor healing of surgical incisions in patients with drainage tube removal after thoracic and abdominal surgery and establish a risk prediction model for poor healing of surgical incisions.Methods:Using the convenient sampling method, a total of 545 patients who underwent thoracic and abdominal surgery in the Affiliated Hospital of Qingdao University were selected from July to December 2020. The patients were divided into the poor wound healing group ( n=87) and the non-incision poor healing group ( n=458) according to whether they had poor wound healing. Logistic regression analysis was used to analyze the risk factors of poor healing of surgical incisions and build a risk prediction model. The receiver operating characteristic (ROC) area under the curve was used to test the model to predict the effect and 230 patients were selected to verify the model prediction effect. Results:In this study, 5 factors including duration of exudation, serum albumin, incision infection, the volume of exudation during catheterization and catheterization time were finally included to construct a risk prediction model. The model formula was Z=4.608+4.855× duration of exudation +3.173× serum albumin +3.739× infection of the incision +2.271×the volume of exudation during catheterization + 0.466× catheterization time. The area under ROC curve of this model was 0.773 (95% CI: 0.678 - 0.868). The maximum value of Youden index was 0.549, the sensitivity was 0.742 and the specificity was 0.807. Conclusions:The risk prediction model of poor incision healing after drainage tube removal for patients undergoing thoracic and abdominal surgery can better predict the risk of poor incision healing and provide a basis for clinical medical staff to take preventive management measures for high-risk patients in time.

Objective With the help of computerized tomography (CT) and susceptibility-weighted imaging (SWI) examinations, to analyze and compare the incidence and the prevalent sites of microbleeds (CMBs) in control group, diabetes group, hypertension group and diabetic hypertension group with intracerebral CMBs. The risk factors for the onset of CMBs also will be explored, in order to provide a basis for the selection of clinical diagnosis and treatment options for CMBs. Methods A collection of 174 non-acute patients in the Department of Neurology of Shandong Electric Power Central Hospital from May 2019 to October 2020, including 101 males and 73 females, aged 45-89 years, with an average age of 72 ± 5 years. Divided into four groups according to disease types: Hypertension with type 2 diabetes group, Hypertension group, Type 2 diabetes group, Control group (no hypertension and type 2 diabetes). All patients underwent CT and MRI SWI sequence scans. The 4 groups of patients were matched in terms of gender and age, excluding the influence of gender and age. The incidence, number and distribution of CMBs in the four groups were counted, and the CT and SWI imaging manifestations of CMBs in the four groups were analyzed and compared. Results CT did not find the incidence of CMBs in the brain of patients. SWI imaging showed that CMBs were detected in 58 of 174 patients (incidence rate 33.3%), and CMBs occurred in 24 cases of diabetes and hypertension group (incidence rate 57.1%). CMBs occurred in 21 cases in the hypertension group (incidence rate 46.7%), 8 cases in the diabetes group (incidence rate 22.2%), and CMBs occurred in 5 cases in the control group (incidence rate 9.8%). The incidence of CMBs in the hypertension group and the diabetes combined with hypertension group was significantly higher than that in the control group (P < 0.05). There was no significant difference in the incidence of CMBs in patients with simple diabetes compared with the control group. Also, there was no significant difference in the incidence of CMBs between the diabetes combined with hypertension group and the simple hypertension group. Conclusion CT did not find the incidence of CMBs in the brains of patients in the non-acute phase. SWI could clearly show the CMBs of the enrolled patients. Diabetes is less likely to cause an increase in CMBs. Hypertension is significantly related to the occurrence of CMBs. CMBs associated with hypertension or/and diabetes are common in the basal ganglia and thalamus, which is different from cerebral amyloid angiopathy, which provides a basis for the choice of clinical treatment options.

Objective:To investigate the prevalence of autism spectrum disorders (ASD)among children in kindergartens in Xi′an urban districts.Methods:A stratified cluster sampling method was adopted, and selected all children from 12 kindergartens in 6 urban districts of Xi′an.Primary screening positive children with ASD were identified by filling out the Autism Behavior Checklist (ABC) by their parents and the guardians reports, and then the beha-vioral observations were made to identify suspicious ASD children.Finally these children were diagnosed in the hospital through the autism diagnostic observation schedule, 2 nd edition (ADOS-2). The data were calculated with SPSS 18.0. Results:Totally, 38 cases with ASD were diagnosed among 5 178 children, the prevalence of children ASD in kindergartens in Xi′an urban districts was 7.3‰, and the 95% confidence interval was 4.98‰-9.62‰.The prevalence of ASD in children was statistically significant in different age groups ( χ2=9.914, P<0.05) and gender groups ( χ2=18.812, P<0.05). The accuracy of ASD screening by guardians reports is better than that by ABC. Conclusions:(1)The prevalence of ASD children in kindergartens in Xi′an urban districts is at high level in similar reports in China.If ASD children at the special education institutions and home are considered, the overall prevalence rate is higher, indicating that the prevalence of ASD children in China may be underestimated.(2)With the increase of age, the attendance rate of ASD children in kindergartens has a decreasing trend.