Objective To evaluate the clinical effect of fluoride agents in prevention of caries in preschool 4 to 5 years old children.Methods 700 kindergartens 4 -5 years old children were selected to conduct prevention study with the agree of guardian.The children were randomly divided into observation group and control group. 350 preschool children in the control group received regular oral health measures and fluoride foam treatment every six months.350 preschool children in the observation group received fluoride products every six months on the basis of the control group.After two years study,the deciduous caries and caries rate of the two groups were analyzed.Results After prevention of dental caries 24 months,the prevalence of dental caries and caries of deciduous teeth surface in the observation group significantly reduced,and were significantly lower than the control group ( observation group:caries prevalence 11.3%,caries mean 0.85;control group:caries prevalence 36.1%,caries mean 1.77),the deciduous caries rate and the number of surface caries between the two groups had statistically significant differences (χ2 =4.339 1,3.016 8,all P<0.05).Conclusion Child deciduous dental caries in China is still at a relatively high inci-dence of disease,regular use of fluoride foam and fluoride products namely fluor protector can significantly prevent dental caries,oral health measures than on a regular basis is more effective,and significantly reduce deciduous caries among children,protection of children's oral health,and it is worth further clinical application.

Objective· To identify the effect and potential mechanism of gambogic acid (GA) on natural killer/T-cell lymphoma (NK/TCL) cell lines.Methods · SNK-1,SNK-6 and SNT-8 were incubated with various concentrations of GA for 24 h,and cell viability was detected with CCK-8 assay.Cell apoptosis was examined by Annexin V-FITC/PI staining assay.Levels of proteins regulating cell apoptosis and phosphorylation levels of proteins in key signaling pathways were detected by Western blotting.Results · GA showed a potent effect on reduction of cell viability of NK/fCL cell lines in CCK-8 assay.GA increased the percentages of Annexin V positive cells and induced activation of caspase-3 and caspase-9,cleavage of PARP as well as the reduction of Bcl-xl.GA also inhibited the phosphorylation levels of STAT3 in SNK-1 and SNT-8,and ERK1/2 in SNK-1 and SNK-6 significantly.Conclusion· GA induces cell apoptosis in NK/TCL cell lines SNK-1,SNK-6 and SNT-8.Anti-apoptosis protein Bcl-xl and signaling pathway JAKs/STATs and MEK/MAPK might be involved in this process.

Objective To identify the expression of transcription factor Sp1 in NK/T-cell lymphoma (NK/TCL) cell lines and to investigate the role of Sp1 in regulation of cell invasion. Methods Real-time PCR, immunofluorescence and Western blot were performed to detect the expression of Sp1 in NK/TCL cell lines SNK-1 and SNK-6 and normal NK cells. Expression levels of IGF-1R and MMP-2 were measured by real-time PCR and Western blot, respectively. Transwell assay was applied to observe the effects of mythramycin A(MIT) on cell invasion. Results Sp1 expression in mRNA and protein were over-expression in NK/TCL cell lines SNK-1 and SNK-6 when compared with normal NK cells. Inhibition of Sp1 by MIT remarkably reduced expression of IGF-1R and MMP-2 in SNK-1, SNK-6 and as a result, or significantly suppressed cell invasion. Expression levels of Sp1 mRNA in SNK-1 and SNK-6 were (9.4±0.3) and (10.6±0.3) foldsincrease as compared with that of control group, respectively (P=0.005 2, P=0.003 7). Levels of Sp1 protein were (5.4±0.3) and (8.6±0.5) foldsincrease times than control groups, respectively (P=0.008 3, P=0.006 9). Inhibition of Sp1 by MIT (100 nmol/L) remarkably reduced expression levels of IGF-1R mRNA by (83.9±3.7) % and (65.8±4.2) % (P = 0.008 2, P = 0.009 7) as compared with controls. Meanwhile, levels of IGF-1R protein were reduced by (51.5±7.1) % and (49.6±9.1) % (P = 0.017 8, P = 0.015 5) as compared with control group. Inhibition of Sp1 by MIT (100 nmol/L) significantly reduced cell invasion and MMP-2 expression in the two cell lines,the cell invasion rates were reduced by (29.6±6.4) % and (37.2±7.6) % (P =0.041 8, P = 0.037 2) in SNK-1 and SNK-6 as compared with control group. The MMP-2 protein levels were found to be (52.7±4.7) % and (29.7±5.6) % (P = 0.028 6, P = 0.020 2) of control group. Conclusion Sp1 is over-expressed in NK/TCL cell lines, and it promotes NK/TCL cell invasion by up-regulating IGF-1R and further increasing MMP-2 expression.

BACKGROUND:Stem cel is a kind of pluripotent cels with self-replication ability, which can differentiate into various cels under certain conditions. Furthermore, stem cels are rich in a variety of growth factors, which can induce the generation of vessels and nerves, and improve the blood supply of lower limbs, thereby achieving the treatment and preventions of lower limb ischemia OBJECTIVE:To summarize and compare the recent achievements in the theory and therapeutic efficacy of stem cels from different sources in the treatment of diabetic foot. METHODS:The first and second authors retrieved PubMed, Sciencedirect and Medline databases for relevant articles published from January 2000 to January 2015. The key words were “diabetic foot, pathogenesis, stem cel therapy” in English. Initialy, 186 articles were retrieved, and finaly 44 articles were included in result analysis. RESULTS AND CONCLUSION:Stem cels can be a new choice for the treatment of diabetic foot. After stem cel therapy, corresponding symptoms have been aleviated, including the generation of new blood vessels and the reshaping of the colateral vessels, the improvement of motor nerve conduction velocity and nerve reflex, the improvement of the sense of skin pain and temperature, and pain relief. It is stil unclear whether alogeneic stem cels are safe or not, but autologous stem cels, especialy bone marrow mesenchymal stem cels, can be better able to repair damaged vessels and nerves and restore the microcirculation of blood supply. Currently, we need to do more basic and clinical researches to solve the folowing problems: to confirm the effectiveness and safety of stem cel therapy for diabetic foot; to identify whether there is a difference in the differentiation and secretory activity between stem cels in diabetic patients and ordinary people; to give ful play to the treatment of diabetic foot.

Objective: To observe the effects of Na⁺ /H⁺ exchanger 1 (NHE1) inhibitor on intestinal injury of rats with burn sepsis, and to explore the possible mechanism preliminarily. Methods: Ninety SD rats were divided into control group, pure sepsis group, and NHE1 inhibitor group according to the random number table, with 30 rats in each group. Full-thickness scald (hereinafter referred to as burn) model with 20% total body surface area were reproduced on the back of rats in pure sepsis and NHE1 inhibitor groups, and then 50 μL liquid of Pseudomonas aeruginosa ATCC 27853 (2×10⁵ colony forming unit/mL) were injected into the center of wounds on the back. Rats in NHE1 inhibitor group were intraperitoneally injected with 0.1 mmol/L NHE1 inhibitor cariporide (0.4 mg/kg) rapidly after the successful establishment of burn sepsis model, while rats in pure sepsis group were injected with the same volume of normal saline. Except for not being made burn wounds nor receiving bacterination, rats in control group were treated the same as those in pure sepsis group. Rats with burn sepsis in each group were laparotomized and injected with 200 mL fluorescein isothiocyanate (FITC)-dextran in the concentration of 0.1 mol/L in terminal ileum at 12 hours post injury, and their left ventricular blood and terminal ileum were collected 30 minutes later. The serum content of FITC-dextran was detected with fluorescence spectrophotometer (n=10); the morphology of intestinal tissue was observed with HE staining (n=10); the content of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in serum and intestinal tissue was determined with enzyme-linked immunosorbent assay (n=20); the activity of myeloperoxidase (MPO) in serum and intestinal tissue was detected with colorimetric method (n=20); the protein expression of nuclear factor-kappa B-p65 (NF-κB-p65) and phosphorylation levels of mitogen-activated protein kinase (MAPK) signal pathway related proteins p38MAPK, extracellular signal-regulated kinase 1/2 (ERK1/2), and c-Jun N-terminal kinase 1/2 (JNK1/2) were determined by Western blotting (n=4). The same samples of rats in control group were collected for related detection at the same time point as above. Data were processed with one-way analysis of variance and SNK test. Results: (1) The serum content of FITC-dextran of rats in pure sepsis group was significantly higher than that in control group (P<0.01), while the serum content of FITC-dextran of rats in NHE1 inhibitor group was significantly lower than that in pure sepsis group (P<0.01). Compared with that in control group, infiltration of a large number of inflammatory cells, ulcer and necrosis of intestinal mucosa of rats in pure sepsis group were observed. The injury condition of intestine of rats in NHE1 inhibitor group was better than that in pure sepsis group. (2) The serum content of IL-6, TNF-α, and MPO of rats in pure sepsis group was (387±42) and (164.7±10.1) ng/mL, and (7.5±1.5) U/mL, respectively, significantly higher than that in control group [(75±17) and (13.1±6.5) ng/mL, and (2.3±0.7) U/mL, respectively, with P values below 0.01]. The serum content of IL-6, TNF-α, and MPO of rats in NHE1 inhibitor group was (176±37) and (64.9±9.3) ng/mL, and (5.9±0.8) U/mL, respectively, which was significantly lower than that in pure sepsis group (with P values below 0.01). (3) The content of IL-6, TNF-α, and MPO in intestinal tissue of rats in pure sepsis group was (190±13) and (172.8±29.7) ng/mL, and (8.7±1.5) U/mL, respectively, significantly higher than that in control group [respectively (20±3) and (11.9±2.3) ng/mL, and (2.9±0.3) U/mL, with P values below 0.01]. The content of IL-6, TNF-α, and MPO of intestinal tissue of rats in NHE1 inhibitor group was (35±6) and (45.2±6.1) ng/mL, and (5.3±0.6) U/mL, respectively, significantly lower than that in pure sepsis group (with P values below 0.01). (4) The protein expression of NF-κB-p65 and phosphorylation levels of p38MAPK and ERK1/2 in intestinal tissue of rats in pure sepsis group were significantly higher than those in control group (with P values below 0.01); the protein expression of NF-κB-p65 and the phosphorylation level of p38MAPK in intestinal tissue of rats in NHE1 inhibitor group were significantly lower than those in pure sepsis group (with P values below 0.01); phosphorylation levels of JNK1/2 in intestinal tissue of rats in the three groups were similar (with P values above 0.05). Conclusions The inhibition of NHE1 can significantly alleviate the intestinal injury, and the mechanisms may be attributed to the regulation of NF-κB and p38MAPK signal pathway, resulting in inhibition of the inflammatory response of intestinal tract.

Objective: To summarize the experience of respiratory tract management in a case of spinal muscular atrophy with neuromuscular scoliosis. Methods: Respiratory tract nursing included prevention of pulmonary infection, inspiratory muscle training, rebuilding respiratory form before surgery, and assessment of sputum expectoration capacity, pain management, airway management after surgery. Results: The patient was discharged without pulmonary complications. Conclusions For patient with breathing problem, respiratory tract management can prevent pulmonary complications during perioperative period.

Objective: To identify the expression pattern of TIM-3 in natural killer/T-cell lymphoma (NK/TCL) cell lines, and to investigate the effect and mechanism of its ligand galectin-9 (GAL-9) inducing apoptosis of NK/TCL cell lines. Methods: Expression of TIM-3 in NK cell of peripheral blood from healthy donors and NK/TCL cell lines (SNK-1、SNK-6、SNT-8) was detected by Western blotting. After being treated with rhGAL-9 at various concentrations for 24h, the cell proliferation ability was analyzed with CCK-8 assay. Apoptosis ratio of the cells was determined by flow cytometry. Expressions of caspase-3, PARP and their cleavages were detected by Western blotting; moreover, phosphorylation levels of proteins in MAPK signaling pathway were also detected by Western blotting. Results: The expression of TIM-3 in SNK-1, SNK-6 and SNT-8 cell lines was significantly higher than that of NK cells from healthy donors (P<0.05). CCK-8 result showed that rhGAL-9 obviously inhibited the proliferation of NK/TCL cell lines in a concentration dependent manner. Flow cytometry showed that rhGAL-9 induced the apoptosis of NK/TCLcells; and Western blotting proved that the expression of cleaved caspase-3, cleaved-PARP, and p-JNK in MAPK signaling pathway were significantly elevated. Conclusion: TIM-3 was over-expressed in NK/TCL cell lines, and its ligand galectin-9 induced cell apoptosis probably through the activation of JNK kinase pathways.

ObjectiveTo investigate the molecular mechanism of the anti-inflammatory effect of Erchentang in the lung tissue of the rat model of chronic obstructive pulmonary disease （COPD） via the heparin-binding factor （Midkine）/transmembrane receptor protein （Notch2）/Hey1 signaling pathway. MethodSixty SD rats were randomized into normal group， model group， modified Erchentang （5， 10， 20 g·kg^-1·d^-1） groups， and Notch1 pathway inhibitor （γ-secretase inhibitor， DAPT， 0.02 g·kg^-1） group， with 10 rats in each group. The rat model of COPD was established by cigarette smoke combined with lipopolysaccharide （LPS）. After the modeling， the rats were administrated with corresponding drugs by gavage， and those in the normal and model groups were administrated with normal saline by gavage for 21 days. The levels of Midkine， cytokine-induced neutrophil chemoattractant-1 （CINC-1）， macrophage-derived chemokine （MDC）， chemokine ligand 5 （CXCL5）， neutrophil elastase （NE）， and nuclear factor-kappa B （NF-κB） p65 in bronchoalveolar lavage fluid （BALF） were determined by enzyme-linked immunosorbent assay （ELISA）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and immunohistochemistry were respectively employed to determine the mRNA and protein levels of Midkine， Notch2， and Hey1 in the lung tissue. ResultCompared with the normal group， the modeling increased the levels of Midkine， CINC-1， MDC， CXCL5， NE， and NF-κB p65 in BALF （P<0.01） and up-regulated the mRNA and protein levels of Midkine， Notch2， and Hey1 in the lung tissue （P<0.01）. Compared with the model group， medium- and high-dose modified Erchentang and DAPT lowered the levels of Midkine， CINC-1， MDC， CXCL5， and NF-κB p65 in BALF （P<0.01） and down-regulated the mRNA levels of Midkine， Notch2， and Hey1 （P<0.01）. ConclusionModified Erchentang may inhibit the inflammation in COPD rats by down-regulating the expression of Midkine， Notch2， and Hey1 and reducing the content of Midkine， CINC-1， MDC， and CXCL5.

Objective:To investigate the diagnostic method and value of echocardiography in screening right patent ductus arteriosus(PDA) of infants.Methods:This was a prospective study.Thirty-one infants with right PDA diagnosed by ultrasound and confirmed by prenatal ultrasonography, electronic computed tomography angiography, angiocardiography and/or surgery in Hebei Children′s Hospital from April 2014 to May 2022 were collected as research subjects, and the association of right ductus arteriosus with aortic arch anomalies and complex cardiac malformations were summarized. The diagnostic method and value of ultrasonic screening were summed up.Results:Of the 31 cases, 30 cases were correctly diagnosed by ultrasound and 1 case was misdiagnosed, who was a left aortic arch descending to the right, a crossover variation of the right and left pulmonary arteries, and a rightward displacement of the ductus arteriosus. Among these cases diagnosed correctly, 27 cases (including 24 cases with right aortic arch and 3 cases with left aortic arch) presented that ductus arteriosus was open and its ostium of pulmonary artery end was located in the proximal right pulmonary artery in views of parasternal short-axis view of great vessels at cardiac base with the combination of two dimensions and color Doppler flow imaging. Other 3 cases of right aortic arch were all single ventricle with transposition of the great artery. Due to the parallel relationship of the two great arteries, the standard parasternal short-axis view of great vessels could not be obtained, and the right ductus arteriosus was found in the high parasternal views.In all of the 27 cases with right aortic arch and right ductus arteriosus, high parasternal views showed that one end of the ductus arteriosus was connected to the right aortic arch isthmus and the other end was connected to the right pulmonary artery. In all of the 3 cases with left aortic arch and right ductus arteriosus, the high parasternal views showed that one end of the ductus arteriosus was connected to the right subclavian artery and the other end was connected to the right pulmonary artery. Among the 27 cases with right aortic arch, 16 cases were accompanied with mirror image branches, 9 cases of which had complex cardiac malformations; 10 cases were associated with aberrant left subclavian artery, 1 case of which had complex cardiac malformations; 1 case was with isolated left subclavian artery, and without complex cardiac malformations. All 3 cases of left aortic arch were accompanied with isolated right subclavian artery and none of them were associated with complex cardiac malformations. Clinical outcomes of 30 cases with right PDA: 14 cases underwent ductus arteriosus ligation due to thick ductus or other heart malformations. In other 16 cases, 4 cases were closed spontaneously, 9 cases had persistent small ductus arteriosus, and 3 cases were lost to follow-up.Conclusions:Right ductus arteriosus is mostly related to the right aortic arch, and those with mirror image branches are prone to complex cardiac malformations; cases of left aortic arch with right ductus arteriosus are tend to accompany isolated right subclavian artery. Ultrasound has an important application in the screening and diagnosis of right PDA.

Objective:To study the correlation between adverse clinical outcomes and early postnatal weight loss(representing the results of fluid management) during hospitalization in extremely premature infants(EPIs).Methods:From January 2019 to March 2023, EPIs (gestational age (GA)<28 weeks) admitted to neonatal intensive care unit(NICU) of our hospital were retrospectively analyzed. According to weight loss (WL) within the first 3 d after birth, the infants were assigned into no-WL group, WL<6% group, WL 6%-10% group and WL>10% group. The following items were compared among the four groups: fluid intake within the first 7 d after birth, the incidences of hemodynamically significant patent ductus arteriosus (hsPDA), PDA requiring surgical ligation, duration of invasive mechanical ventilation, ≥stage II necrotizing enterocolitis(NEC), grade 3-4 intraventricular hemorrhage(IVH), moderate bronchopulmonary dysplasia (BPD), severe BPD, mortality rates and total length of hospital stay.Results:A total of 119 EPIs were enrolled, including 41 in no-WL group, 22 in WL<6% group, 31 in WL 6%-10% group and 25 in WL>10% group. Among the four groups, no significant differences existed in fluid intake on d1 and d5-d7 after birth ( P>0.05). WL 6%-10% and >10% groups had significantly lower fluid intake during d2-d4 than no-WL group ( P<0.05).On d4, WL 6%-10% and >10% groups had lower fluid intake than WL <6% and no-WL groups( P<0.05).WL 6%-10% and >10% groups showed lower incidences of hsPDA than no-WL group ( P<0.05).WL>10% group had lower incidences of ≥stage II NEC, moderate BPD, shorter duration of invasive mechanical ventilation and total hospital stay than no-WL group( P<0.05). No significant differences existed in the incidences of PDA requiring surgical ligation, grade 3-4 IVH, severe BPD and mortality rates among the four groups ( P>0.05). Conclusions:For EPIs, a certain degree of WL within the first 3 d after birth is beneficial to reduce the incidences of hsPDA, NEC, moderate BPD, duration of invasive mechanical ventilation and total hospital stay. Focusing on body weight is helpful for a more optimal fluid management strategy in the early postnatal period.