Objective To investigate clinical effect of file hand stainless steel and nickel -titanium instru-ment combined with sonic endodontic on chronic periapical periodontitis for C -shaped root canals in mandibular sec-ond molars.Methods 140 patients with chronic periapical periodontitis for C -shaped root canals in mandibular sec-ond molar were chosen and randomly divided into two groups,including A group (70 patients)with file hand stainless steel and B group (70patients)with sonic endodontic combined with nickel -titanium instrument.The following -up success rate of root canal therapy,filling quality of root canal,incidence of pain reaction and complication of root canal preparation between the two groups were compared.Results The following -up success rate of root canal therapy in 6 months after treatment of A group and B group were 32.86%(23 /70),67.14%(47 /70).The following -up suc-cess rate of root canal therapy in 12 months after treatment of A group and B group were 64.29%(45 /70),72.86%(51 /70).The following -up success rate of root canal therapy in 6 months after treatment of B group was significantly higher than A group(χ2 =10.27,P <0.05).There was no significant difference in following -up success rate of root canal therapy in 12 months after treatment between the two groups(χ2 =2.14,P >0.05).The good filling rate of root canal of B group was significantly higher than A group(χ2 =9.70,P <0.05).The incidence rates of pain reaction of A group and B group were 48.57%(34 /70),21.43%(15 /70).The incidence rate of pain reaction of B group was significantly lower than A group(χ2 =12.15,P <0.05).The incidence rates of apical foramen deformation,wall perforation and step formation of A group were 6.54%(14 /214),0.93%(2 /214),7.94%(17 /214),those of A group were 7.73%(17 /220),0.91%(2 /220),1.82%(4 /220).The incidence rate of step formation of B group was significantly lower than A group (χ2 =11.14,P <0.05 ).There were no significant differences in the incidence rates of apical foramen deformation and wall perforation between the two groups (χ2 =3.11,1.06,P >0.05 ). Conclusion Nickel -titanium instrument combined with sonic endodontic on chronic periapical periodontitis for C -shaped root canals in mandibular second molars can efficiently improve rational symptoms,enhance filling quality of root canals and reduce pain degree and complication risk,the effect is better than file hand stainless steel for canal preparation.

BACKGROUND:Severely curved root canal preparation is the difficulty during clinical root canal preparation, and improper preparation may induce complications such as stage, root canal offset and apical open, which affect the quality of root canal preparation and apical closure. Therefore, it is important to choose a root canal preparation instrument which has the best cutting and forming ability. OBJECTIVE: To compare the shaping ability of Mtwo nickel-titanium rotary instruments, K3 nickel-titanium rotary instruments and stainless steel K-files for the preparation of curved root canals. METHODS:A total of 30 severely curved root canals of freshly extracted human maxilary molars were randomly divided into three groups, with 10 canals in each group. The canals were prepared by Mtwo instruments, K3 instruments and K-files, respectively. The instrument’s tip location in pre- and post-instrumentation radiographs of the three groups was recorded; the changes of root curvature, working length and working time in the three groups were measured and compared. RESULTS AND CONCLUSION:The root curvature showed no significant difference in the three groups before preparation (P> 0.05). The changes of root curvature after root preparation in Mtwo instrument and K3 instrument groups were significantly less than that in K-files group (P < 0.01), and no significant difference was found between Mtwo instrument group and K3 instrument group (P > 0.05). The root canal preparation time in the three groups showed significant differences (P < 0.01), which was the shortest in Mtwo instrument group and the longest in K-files group. The changes of working length after root preparation in the three groups showed no significant difference (P > 0.05). Mtwo nickel-titanium rotary instruments and K3 nickel-titanium rotary instruments are have high efficacy and strong shaping ability in preparing curved root canals.

Objective To study the genotyping distribution of the Yersinia pestis(Y.pestis)strains by characterizing the diversity of the insertion sequence IS100 within the Y.pestis genome.Methods Derived fromthe known sequence of oriental strain CO92,5 pairs of locus-specific primers originating from both sides of the adjacent region of IS100 copies were designed,and two other complementary primers inside the IS100 sequence were designed to correspond with the outer primers.Then,91 Y.pestis strains and l pseudotubebculosis strain were tested by the specific PCR method using the primers described above and the PCR products were conformed by the sequence analysis,then further analysis WaS performed after the IS100 status was marked on the map of the plague focus type of china.Results The 91 Y.pestis strains had different IS100 status in their genome on tested loci.some possessed IS100 insertion,some didn't,and others changed their genome constitution.The IS100 possession on the 5 loci also suggested a distribution of regionality.Conclusion The analysis of some IS100 insertion element loci reveals that the IS100 genotyping distribution is consistent with the plague focus of type of China.And IS100genotyping pattern of the Y.pestis stains well reflects its genome constitution and the high flowability in its natural evolution.

Objective:To explore the effect of joint segmentation model of myocardial-fibrotic region based on deep learning in quantitative analysis of myocardial fibrosis in patients with dilated cardiomyopathy(DCM).Methods:The data of 200 patients with confirmed DCM and myocardial fibrosis in the left ventricle detected by cardiac MR-late gadolinium enhancement (CMR-LGE) in Xuzhou Central Hospital from January 2015 to April 2022 were retrospectively analyzed. Using a complete randomized design, the patients were divided into training set ( n=120), validation set ( n=30) and test set ( n=50). The left ventricle myocardium was outlined and the normal myocardial region was selected by radiologists. Fibrotic myocardium was extracted through calculating the threshold with standard deviation (SD) as a reference standard for left ventricle segmentation and fibrosis quantification. The left ventricular myocardium was segmented by convex prior U-Net network. Then the normal myocardial image block was recognized by VGG image classification network, and the fibrosis myocardium was extracted by SD threshold. The myocardial segmentation effect was evaluated using precision, recall, intersection over union (IOU) and Dice coefficient. The consistency of myocardial fibrosis ratio in left ventricle obtained by joint segmentation model and manual extraction was evaluated with intra-class correlation coefficient (ICC). According to the median of fibrosis rate, the samples were divided into mild and severe fibrosis, and the quantitative effect of fibrosis was compared by Mann-Whitney U test. Results:In the test set, the precision of myocardial segmentation was 0.827 (0.799, 0.854), the recall was 0.849 (0.822, 0.876), the IOU was 0.788 (0.760, 0.816), and the Dice coefficient was 0.832 (0.807, 0.857). The consistency of fibrosis ratio between joint segmentation model and manual extraction was high (ICC=0.991, P<0.001). No statistically significant difference was found in the ratio error between mild and severe fibrosis ( P>0.05). Conclusions:The joint segmentation model realizes the automatic calculation of myocardial fibrosis ratio in left ventricle, which is highly consistent with the results of manual extraction. Therefore, it can accurately realize the automatic quantitative analysis of myocardial fibrosis in patients with dilated cardiomyopathy.

Objective:To explore the influence of airway mucus plugs on patients with bronchial asthma and its management.Methods:In this cross-sectional study, from January 2020 to June 2022, 100 patients who were diagnosed with asthma and underwent chest CT examination in the Outpatient Department of Peking University Third Hospital were included. The chest CT results and medical history, pulmonary function, fractional exhaled nitric oxide (FeNO), blood routine, total allergen IgE, Aspergillus fumigatus M3 allergen-specific IgE antibody test results were collected. According to the results of chest CT, the asthma patients were divided into group with mucus plugs and those without mucus plugs. Distribution of airway mucus plugs and the mucus plug scores based on lung segments were calculated. The relationships of mucus plugs with medical history, pulmonary function [These included before and after the bronchodilation test, forced vital capacity percent of predicted value (FVC%pred), forced expiratory volume in one second percent of predicted value (FEV 1%pred), FEV 1/FVC, peak expiratory flow percent of predicted value (PEF%pred), maximal mid-expiratory flow percent of predicted value (MMEF%pred), maximal expiratory flow at 25%, 50%, 75% of vital capacity remaining percent of predicted value (MEF 25%pred, MEF 50%pred, MEF 75%pred)], FeNO, and peripheral blood eosinophil (Eos) counts were analyzed. The logistic regression model was used to analyze whether airway mucus plug was a risk factor for asthma exacerbation, and the corresponding intervention strategies were explored. Results:Among the 100 patients with asthma, 24 cases were in the mucus plug group and 76 cases were in the non-mucus plug group. The distribution of mucus plug was more common in the lower lungs (30.53% and 9.16% in the lower and upper lobe of left lung, respectively; 29.01%, 14.50% and 16.80% in the lower, middle and upper lobe of right lung, respectively). The average score of mucus plug was (4.42±3.12) points. The body mass index (BMI), the number of visits to a doctor due to asthma exacerbations, FeNO, peripheral blood Eos counts in the mucus plug group were higher than those in the non-mucus plug group [(24.95±4.34) vs (23.22±2.91) kg/m 2, 0(0, 1) vs 0(0, 0), 97(37, 169) vs 31(18, 59) ppb (1 ppb=1×10 -9), 0.41(0.15, 0.70) vs 0.18(0.09, 0.37)×10 9/L](all P<0.05), and FVC%pred, FEV 1%pred, FEV 1/FVC, PEF%pred, MEF 50%pred, MEF 25%pred, MMEF%pred, MEF 75%pred were lower than those in the non-mucus plug group [(87.49±19.32)% vs (97.34±14.24)%, (76.49±19.58)% vs (91.07±18.33)%, (72.44±10.91)% vs (79.48±8.13)%, (82.36±24.46)% vs (93.83±18.27)%, (53.03±24.81)% vs (75.75±27.15)%, (46.47±22.92)% vs (64.09±25.90)%, (50.28±23.73)% vs (74.53±26.80)%, (71.30±27.55)% vs (89.92±26.82)%] (all P<0.05). In the group with mucus plug, the airway mucus plug score was positively correlated with the patient′s body weight and the number of peripheral blood Eos counts at enrollment ( r=0.413, 0.478; all P<0.05), and negatively correlated with FVC%pred and FEV 1%pred ( r=-0.576, -0.465; all P<0.05). Logistic regression analysis showed that airway mucus plug score was a risk factor for acute asthma attack ( OR=1.269, 95% CI: 1.031-1.562; P=0.024). Conclusions:Asthma patients have a high incidence of airway mucus plug, which is related to the level of Eos inflammation and body size. Airway mucus plugs can promote airflow obstruction and acute exacerbation of asthma. In clinical practice, appropriate asthma management policies can be formulated for airway mucus plugs to delay the progression of asthma and reduce the number of acute attacks.

Objective To compare FibroTouch, serum hepatic fibrosis index and aspartate aminotransferase-to-platelet ratio index (APRI) in diagnosis of liver fibrosis and early cirrhosis for patients with chronic HBV infection with mild abnormal liver function.Methods One hundred and seven chronic HBV infected patients with alanine transaminase (ALT)≤80 U／L who underwent liver biopsy in Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2014 to January 2017 were enrolled in the study.According to the liver biopsy pathology , the patients were divided into mild liver fibrosis group (S1, n＝26 ), significant fibrosis group ( S2-3, n ＝34 ) and early cirrhosis group ( S4, n ＝47 ).The differentiations of liver stiffness measurement (LSM), Laminin(LN), Collagen Type ⅢN-peptide(PⅢP N-P), Collagen Type IV(CⅣ), Hyaluronic acid ( HA) and APRI were compared among the three groups , and their correlations with fibrosis were analyzed with Spearman rank correlation analysis .Logistic regression analysis was performed to establish a multi-index model for predicting the degree of liver fibrosis , and the receiver operating characteristic (ROC) curves were drawn to compare and analyze the predictive value for different stages of liver fibrosis.Results The LSM in the significant fibrosis group was higher than that in the mild liver fibrosis group (Z＝-2.611, P＜0.01).The levels of PⅢP N-P,CIV,LN and HA in early cirrhosis group were higher than those in mild liver fibrosis group (Z＝-4.026,-4.205,-2.938 and-3.156, all P＜0.01).LSM and APRI in early liver cirrhosis group was higher than that in mild liver fibrosis group(Z＝-5.789 and -4.308, both P＜0.01) and significant liver fibrosis group (Z＝-3.460 and -3.498, both P＜0.01).PLT in early liver cirrhosis group was lower than that in mild liver fibrosis group and significant liver fibrosis group (Z＝-4.533 and -3.206, both P＜0.01).The correlation analysis showed that the values of LSM , CIV, PⅢP N-P and APRI were positively correlated with the stage of liver fibrosis (r＝0.606, 0.418, 0.396 and 0.470, respectively; all P＜0.01).There was no significant difference in the efficacy of each single index in predicting hepatic fibrosis S≥2 and S＝4 (all P＞0.05). The prediction of liver fibrosis models were established with Logistic regression analysis .The model 1 Logit (P)＝-3.810+0.385×LSM+0.052×CIV was used for predicting liver fibrosis S≥2; the area under the receiver operating characteristic curve ( AUC) was 0.839, with specificity of 96.0%, and the diagnostic efficacy was superior to PⅢP N-P, CⅣand APRI(Z＝2.579, 2.145 and 2.219, all P＜0.05), but there was no significant difference compared with LSM ( Z ＝1.001, P ＞0.05).The model 2 Logit ( P)＝-4.291+0.105×LSM+0.028×CIV+2.682×APRI was used for predicting liver fibrosis S ＝4; its AUC was 0.865 with sensitivity of 82.9%and specificity of 81.8%, and the diagnostic efficacy was superior to LSM, PⅢP N-P, CⅣand APRI (Z＝2.309, 2.485, 2.403 and 2.103, all P＜0.05).Conclusions For chronic HBV infected patients with mild abnormal liver function , FibroTouch can be selected as a noninvasive method to predict liver fibrosis S≥2.The diagnostic efficacy of the prediction model 2, based on the combination of LSM, CIV and APRI is superior to each single index , which can improve the prediction level of early cirrhosis.

Objective:To study the correlation between peripheral blood eosinophils levels and clinical characteristics of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:A retrospective study was conducted in 79 AECOPD patients admitted to the Department of Respiratory and Critical Care Medicine of Peking University Third Hospital from January 2015 to December 2016. Peripheral blood EOS level 100/μl, 300/μl, 2%, 3%, and sputum EOS level 3% were the cut-off values. Patients were divided into EOS≥100/μl group ( n=33), EOS<100/μl group ( n=46); EOS≥300/μl group ( n=10), EOS<300/μl group ( n=69); EOS%≥2% group ( n=27), EOS<2% group ( n=52); blood EOS≥3% group ( n=16), blood EOS<3% group ( n=63); sputum EOS≥3% group ( n=7), sputum EOS<3% group ( n=15) respectively. The study analyzed the differences of clinical features between each two groups of patients; According to the blood EOS level in the acute phase and the recovery phase, ≥100/μl was high and<100/μl was low, they were divided into high EOS in both acute and recovery phase group ( n=21), high EOS in the acute phase and low EOS in the recovery phase group ( n=4), low EOS in the acute phase and high EOS in the recovery phase group ( n=20) and low EOS in both acute and recovery phase group ( n=12). The differences of clinical characteristics in each group were analyzed. Results:The median duration of COPD, proportion of patients with forced expiratory volume in the first second (FEV 1) percentage of predicted value (FEV 1% predicted value)<50%, proportion of complicated with respiratory failure, median level of procalcitonin, proportion of systemic glucocorticoid therapy and median length of stay in the EOS≥100/μl group were all significantly lower than EOS<100/μl group (5 vs 13 years, 48.0% vs 81.8%, 21.9% vs 50.0%, 0.04 vs 0.09 μg/L, 21.2% vs 56.5%, 11 vs 14 d, all P<0.05). The proportion of re-acute exacerbation in the EOS≥300/μl group was significantly higher than EOS<300/μl group (60.0% vs 23.2%), while the median fibrinogen level and median procalcitonin level were significantly lower than EOS<300/μl group (3.38 vs 3.85 g/L, 0.03 vs 0.07 μg/L, all P<0.05). The median duration of COPD, proportion of FEV 1% predicted value<50%, proportion of complicated with respiratory failure, the modified British Medical Research Council′s dyspnea scale (mMRC) score, median fibrinogen level, median C-reactive protein level, median procalcitonin level, proportion of systemic glucocorticoid therapy, proportion of non-invasive ventilation during hospitalization and median length of stay in the EOS≥2% group were all significantly lower than EOS<2% group [5 vs 13 years, 40.9% vs 83.3%, 12.0% vs 51.0%, 3 (2, 3) vs 3 (3, 4) points, 3.37 vs 3.97 g/L, 3.6 vs 16.8 mg/L, 0.04 vs 0.09 μg/L, 14.8% vs 55.8%, 0 vs 19.2%, 9 vs 14 d] (all P<0.05). The median duration of COPD, proportion of complicated with respiratory failure, median level of C-reactive protein and proportion of systemic glucocorticoid therapy in the blood EOS≥3% group were significantly lower than blood EOS<3% group (5 vs 10 years, 6.7% vs 45.8%, 4.4 vs 12.9 mg/L, 12.5% vs 49.2%) (all P<0.05). The median duration of COPD and median length of stay in the sputum EOS≥3% group were significantly shorter than sputum EOS<3% group (2 vs 15 years, 10 vs 21 d), while the median blood EOS count and median blood EOS ratio were significantly higher than sputum EOS<3% group (0.20 vs 0.01×10 9/L, 2.4% vs 0.1%) (all P<0.05). The proportion of complicated with respiratory failure and received systemic glucocorticoid therapy in the high EOS in both acute and recovery phase group were significantly lower than the low EOS in the acute phase and high EOS in the recovery phase group (14.3% vs 75.0%, 14.3% vs 55.0%) (all P<0.05). The proportion of FEV 1% predicted value <50% in the high EOS in the acute phase and low EOS in the recovery phase group was significantly lower than the low EOS in the acute phase and high EOS in the recovery phase group (0 vs 82.4%) ( P<0.05). The median FEV1% predicted value level in the high EOS in the acute phase and low EOS in the recovery phase group was significantly higher than the low EOS in both acute and recovery phase group (59.5% vs 36.0%) ( P<0.05). Conclusions:High EOS AECOPD patients have a shorter duration of disease and fewer days of hospitalization. The proportion of patients complicated with respiratory failure is lower. It is easier to distinguish the differences in clinical characteristics of AECOPD patients with a blood EOS count of 100/μl as a cut-off value. EOS levels in the acute phase and the recovery phase are helpful to distinguish the clinical characteristics of AECOPD patients.

Objective:To investigate the clinical efficacy of P-GEMOX (pegaspargase, gemcitabine and oxaliplatin) as a first-line regimen for the treatment of primary extranasal nasal-type NK/T cell lymphoma (NKTCL).Methods:The clinical manifestations, treatment response and prognosis of 7 patients with primary extranasal nasal-type NKTCL who underwent P-GEMOX chemotherapy as a first-line therapy in Shenzhen People's Hospital from September 2015 to October 2018 were retrospectively analyzed.Results:The median age of 7 patients with primary extranasal nasal-type NKTCL was 41 years old (27-74 years old), which was more commonly found in males (6 cases); the primary and invading extranasal sites included ileocecal, lymph nodes, skin, testis, adrenal gland, central nervous system, etc. The P-GEMOX regimen was used as a first-line therapy, although some patients had a short-term effect, all patients eventually progressed rapidly and died. The overall survival time was 2 weeks to 21 months.Conclusion:The short-term efficacy of P-GEMOX as a first-line therapy for the treatment of primary extranasal nasal-type NKTCL is acceptable, but the long-term efficacy is poor.

INTRODUCTION: There is limited literature on clinical outcomes following percutaneous coronary intervention (PCI) in Asian dialysis patients. We evaluated the angiographic characteristics and clinical outcomes of dialysis patients treated with PCI in an Asian society. METHODS: A retrospective analysis was performed of 274 dialysis patients who underwent PCI in a tertiary care institution from January 2007 to December 2012. Data on clinical and angiographic characteristics was collected. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of cardiac death, acute myocardial infarction (AMI) and stroke at two years. RESULTS: 274 patients (65.0% male, median age 62.0 years) with 336 lesions (81.8% Type B2) were treated. 431 stents (35.0% drug-eluting stents) with a mean diameter of 2.96 mm and mean length of 21.30 mm were implanted. The MACE rate was 55.8% (n = 153) at two years, from death (36.5%) and AMI (35.0%). In multivariable analysis, age and diabetes mellitus were significant predictors of both mortality (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.05-1.12, p < 0.001; OR 2.65, 95% CI 1.46-4.82, p = 0.001, respectively) and MACE (OR 1.06, 95% CI 1.03-1.08, p < 0.001; OR 1.84, 95% CI 1.07-3.15, p = 0.027, respectively). Left ventricular ejection fraction (LVEF) (OR 0.97, 95% CI 0.95-0.99, p = 0.006) was a significant predictor of mortality but not MACE. CONCLUSION Asian dialysis patients who underwent PCI had a two-year MACE rate of 55.8% due to death and AMI. Age, LVEF and diabetes mellitus were significant predictors of mortality at two years.

Objective: To analyze the serotype distribution and antibiotic resistance characteristics of food-borne Salmonella strains isolated from food and patients with gastroenteritis in Guizhou Province from 2016 to 2018. Methods: Serotypes of the strains were characterised using slid agglutination method with Salmonella antisera. Minimal inhibitory concentrations (MIC) of antibiotics were determined by the broth microdilution method. Microsoft Excel 2007 and SPSS18.0 were used for statistical analysis. Results: A total of 170 strains of food-borne Salmonella were detected in food and patients with gastroenteritis in Guizhou Province from 2016 to 2018. Thirty-five serotypes were identified and 6 were found in both food and patients. The main serotypes in food were Salmonella Typhimurium (16.67%) and Salmonella Stanley (8.33%), and the predominant serotypes in patients were Salmonella Typhimurium (41.79%), Salmonella Enteritidis (16.42%) and Salmonella London (8.96%). The rate of resistance to ampicillin, chloramphenicol, tetracycline, ciprofloxacin, nalidixic and trimeth-sulfame were 27.78%-33.33% among the isolates from food, and 22.22%-25.00% to gentamicin, cefocime and ampicillin/sulbatan. Among the isolates from patients, the highest resistance was to ampicillin (55.97%), followed by that to tetracycline (49.25%), ampicillin/sulbatan (44.03%), nalidixic acid (41.04%) and cefazolin (37.31%), and 20.90%-30.60% strains were resistant to chloramphenicol, ciprofloxacin, gentamicin, cefotaxime and ampicillin/sulbatan. There were 25.00% isolates from food and 25.37% isolates from patients resistant to at least 6 antibiotics, and the main multi-resistant pattern was ampicillin-tetracyline-nalidixic-cephalosporin antibiotics (partial). Conclusions There were many kinds of serotypes of food-borne Salmonella in Guizhou Province from 2016 to 2018 and the predominant types were Salmonella Typhimurium, Salmonella Enteritidis and Salmonella London. Drug resistance was common in the strars and some multidrug resistant strains were detected.