Objective To Study the effect of efflux pump-inhibitors(EPI)-Verapamil in photodynamic therapy (PDT) using hematoporphyrin monomethylether (HMME) as photosensitizer on the cariogenic bacteria in dental plaque biofilms.Methods According to the administrator order of the verapamil and photosensitizer in PDT,streptococcus mutans,streptococcus sanguis,eosinophilic lactobacillus and actinomyces viscosus were used to establish the dental plaque biofilm model.The experiment was divided into five groups,group A was incubated with the photosensitizer and verapamil group,group B using verapamil before incubated the photosensitize,group C suing photosensitizer before incubated verapamil,group D with PDT only,group E was control group.After laser treatment,the influence of the dental plaque biofilms was observed by confocal laser scanning microscope.Results As saline-treated group is a group of normal the dental plaque biofilms.In PDT only group,compared with the saline group,red fluorescence increased significantly,the bacteria lose accumulation capacity,and were isolated and scattered in dispersed state.In PDT plus verapamil group,compared with only PDT group,green staining increased,bacterial activity increased.In group B,cells were incubated with verapamil before incubated the photosensitizer group,green staining increased significantly,red fluorescence reduced,indicating live bacteria increased,and bacteria activity was significantly increased.Conclusion PDT is an effective method in eliminating cariogenic bacteria of dental plaque biofilms.Bacterial efflux pump inhibitors can lower HMME-PDT inhibition cariogenic bacteria in dental plaque biofilm,and pre-verapamil administration could significantly inhibit the effect of PDT treatment of dental caries.

Objective The purpose of this study was to assess the antibacterial effects of hematoporphyrin monomethylether-photodynamic therapy (HMME-PDT) on Enterococcus faecalis within infected simulated lateral canals in vitro with different energy.Methods Simulated lateral canals were prepared on extracted teeth.The specimens were infected with Enterococcus faecalis and then were randomly divided into eight groups.Group A was considered as negative control,its specimens were irrigated with physiological saline.Group B was the positive control,they were irrigated with 5.25％ NaClO.Other groups were incubated with HMME at concentration of 40 μg/ml for 5 min,followed by exposure to light at 532 nm for 120 s with different powers in a spiral pattern.Groups were named C-H,in corresponding with the power 50,60,70,80,90,100 mW.Microbial samples (the dentin chips from simulated lateral canals) were taken before and after the treatments.The survival fractions in each simulated lateral canal was calculated by counting colony-forming units(CFUs).Results 1.The HMME-PDT-treated groups resulted in a significant reduction in the number of E.faecalis in simulated lateral canals compared with the negative controls(P＜0.05).2.The antibacterial effects of group D、E、F、G、H were higher than the NaCl0-irrigated group(P＜0.05).3.The difference of antibacterial effects between the F、G、H groups was in significant(P＞0.05).Conclusion HMME-PDT had significant inhibitive efficacy on Enterococcus faecalis within infected simulated lateral canals and the efficacy was power-depended.It can play the best effect with the power of 80 mW.

Objective To establish a method of isolation, purification and identification of type Ⅱ alveolar epithelial cells (AEC- K ) from neonate piglet lungs of 1 ～ 3 days old and to investigate effects of proinflammatory cytokines on expression of growth factors (GFs). The yield, viability and purity of AEC- Ⅱ obtained using different enzyme digestion and purifying methods were compared. Methods After the first 24-hour culture of AEC- Ⅱ ,the media containing interleukin (IL)-1β,IL-6 and IGF-Ⅰ at different concentrations were used to culture AEC-Ⅱ for another 48 hours. And then the cells were counted and the expressions of insulin-like growth factor (IGF-Ⅰ ), platelet-derived growth factor ( PDGF), surfactant proteins (SP) -A and SP-B mRNA were determined by real time PCR. Results A significantly higher yield of AEC-Ⅱ was achieved by digesting the lung with 30 unit/ml elastase and 0.1 % trypsin at 37 t for 20 min, the yield was (5.33 ±0.54) × 106 after adjusted by the weight of lung and heart (P <0.01). The number of purified AEC-II obtained by immune adherence method was (38.0 ±28.0) × 106 perpiglet which was higher than by the method of percoll. The optimal phenotype maintenance time of AEC- Ⅱ was the first 24～96 hours in the primary culture. With increasing concentrations of IL-1 β and IL-6, there were decreased proliferation and expression of SP-A and IGF-Ⅰ mRNA in the cultured AEC- Ⅱ ,but SP-B mRNA expression was not affected. Both AEC-Ⅱ proliferation and expression of SP-A, SP-B mRNA decreased significantly after cultured with anti-IGF-Ⅰ. Conclusion In a new model of cultured AEC-Ⅱ from neonate piglets, IL-1β and IL-6 inhibited AEC- Ⅱ proliferation and SP-A mRNA expression through IGF-Ⅰ -dependent mechanisms.

Background and purpose: When patients have positive sentinel lymph node (SLN), axillary lymph node dissection (ALND) is usually performed, but most of them have no metastasis in the non-sentinel lymph node (nSLN). It is of great significance to predict metastasis of nSLN precisely. The aim of the study was to establish a nomogram for the intraoperative prediction of nSLN metastasis in breast cancer patients using one-step nucleic acid amplification (OSNA) techniques and to direct the subsequent therapy for breast cancer effectively. Methods: Of 552 breast cancer patients who underwent SLN biopsy in the 2010 OSNA clinical trial, 103 with SLN metastasis treated with ALND were assessed to establish a nomogram for intraoperative prediction of nSLN based on the molecular diagnosis. A validation cohort of 61 patients who met the similar criteria in the 2015 OSNA clinical trial subsequently validated it. Results: Primary tumor size, total tumor load, the number of positive SLNs and negative SLNs were associated with the presence of nSLN metastasis based on the multivariable logistic regression results, and a nomogram was established with these variables. Its area under the ROC curve was 0.814 for the predictive model and it was 0.842 in the re-validation cohort. The tumor size assessed by the postoperative histological examination was replaced by the size evaluated by the imaging examination, and the area under the ROC curve was 0.838. There was no statistically significant difference in the accuracy compared with the former validation data (P=0.7406). Conclusion: The predictive nomogram based on the molecular diagnosis can predict the nSLN metastases intra/post-operatively. It appears to be obviously superior to other predictive models and may help to guide the axillary management and to make decisions about radiation target region.

Background and purpose:Cancer is a major public health issue in China and worldwide, which se-riously threatens human beings as well as social and economic development. This study explored the relationships between the cancer distribution characteristics and cancer prevalences in Chinese cancer surveillance regions to provide scientific evidence for cancer prevention and management.Methods:The data were obtained from the book named“Prevalence and Mortality of Cancer in China from 2003-2007” including incidence of 23 cancer types in 32 regions of China published by the Academy of Military Medical Sciences of the Chinese PLA in 2012. Correspondence analysis was used to gain the relation between the prevalence and area distribution. Cluster analysis was used to obtain the classifications with special significance by putting the cancers or regions with similar characteristics into a cluster.Results:Esophageal cancer, gastric cancer, liver cancer, lung cancer, colorectal and anal cancer have high incidence and mortality in both genders. The districts with high incidence of esophageal cancer and gastric cancer were grouped together. The counties or cities (Shexian, Yangcheng, Linzhou, Yanting, Yangzhong and Jianhu) with high incidence of esophageal cancer and gastric cancer were classified into same cluster frequently. Fusui was grouped along because of the lower incidence of various cancers than the national average except for liver cancer. Guangzhou, Sihui and Zhongshan were the districts with high incidence of nasopharyngeal carcinoma in both genders. Rural areas in Qidong and Haimen were classified into a cluster in male and total data for the high incidence of liver cancer. Colorectal cancer, anal cancer and breast cancer in women also had high incidence in urban areas. Cervical cancer had the second level high incidence in women following diseases of digestive system, breast cancer and lung cancer.Conclusion:Similar pathogenic factors may exist in counties or cities of Shexian, Cixian, Yangcheng,etc, because of the high prevalence of esophageal cancer. Similar pathogenic factors may also exist in other districts or cancers that were classified into the same cluster.

ObjectiveTo establish a method for measuring exhaled nitric oxide (eNO)concentrations in neonates with and without hypoxemic respiratory failure ( HRF), and to investigate the relationship between eNO and respiratory parameters in neonates with HRF. Methods Twenty-two newborn infants with HRF and 26 control neonates were included within the first 24 hours of postnatal life.Their eNO levels were detected with a rapid-response chemiluminescence analyzer daily during the first week of their postnatal life, and lung mechanics and gas exchange efficiency were monitored at the same time, such as pulse oxygen saturation ( SpO2 ), inspired fraction of oxygen ( FiO2 ) and other parameters.Wilcoxon Mann-Whitney U tests were used to compare eNO, SpO2/FiO2 and eNO/ ( SpO2/FiO2 × 100) in two groups. Pearson's correlation analyses were used to determine the relationships between eNO levels and indices of hypoxemic respiratory failure. ResultsDuring the first two days of postnatal life, eNO values of HRF neonates were higher than those of the control neonates[day 1,(7. 9 ± 3.2 )× 10-9 vs. (5.8 ±1.8)×10-9, P＜0.05;day2, (8.8±3.2)×10-9vs. (6.0±2.4)×10-9, P＜0. 05], butthere were no significant differences in the following days. With SpO2/FiO2 increasing, difference of eNO values between the HRF and non-HRF controls became narrowed, but there was still two fold difference of eNO/(SpO2/FiO2 × 100) on day 5-7. ConclusionsA method for measuring eNO was established and there was difference in neonates with and without HRF, which diminished with prolonged postnatal days, reflecting pathophysiological characteristics of HRF.

Objective To investigate the protective effect of fibrinolytic therapy on renal function in patients with IgA nephropathy. Methods The clinical data of 84 patients with idiopathic IgA nephropathy were analyzed in a retrospective cohort study. According to different drugs of fibrinolytic therapy, the patients were divided into three groups including control group(n=23), urokinase group (n=32) and fibrinogenase group (n=29). Twenty-four-hour urine protein excretion, serum albumin, estimated glomerular filtration rate (eGFR), prothrombin time and fibrinogen level between the three groups after 6-month and 1-year treatments were compared. Results Compared to the group before treatment, the urine protein excretions were decreased in all 3 groups with 6-month and 1-year treatments (P<0.01). The urine protein excretion in the urokinase group with 6-month and 1-year treatments were lower than that in the control group (P<0.01). The urine protein excretion in the fibrinogenase group with 1-year treatment were lower that in the control group (P<0.05). After 1-year treatment, the eGFR in urokinase group was significantly increased compared with the control group (P<0.05). Conclusion Fibrinolytic therapy can decrease the 24-hour urine protein excretion and improve the renal fuction in those patients with idiopathic IgA nephropathy independent of glucocorticoids and immunosuppressive agents.

OBJECTIVE:To determine the contents of citric acid in fentanyl citrate raw materials and its injection by ion chro-matography. METHODS:The determination was performed on Thermo Dionex IonPacTM AS11-HC column with mobile phase con-sisted of potassium hydroxide (gradient elution) at the flow rate of 1.0 mL/min. The column temperature was 35 ℃,and sample size was 20 μL. The detector was suppressed conductivity detector. RESULTS:The linear range of citric acid were 0.1157-74.05 μg/mL(r=0.9995). The limit of quantitation was 0.1150 μg/mL,and the limit of detection was 0.0400 μg/mL;RSDs of preci-sion,stability and reproducibility tests were all lower than 2.0%;the average recoveries were 99.6%-101.5%(RSD=0.68%,n=9). CONCLUSIONS:The method is environmentally-friendly and simple with good accuracy and precision,and suitable for the contents determination of citric acid in fentanyl citrate raw materials and injection.

Objective:To investigate the effect of the application of "internet +" disease management based on the AISAS model on the young and middle-aged patients after PCI therapy.Method:A total of 90 young and middle-aged patients hospitalized in cardiological department of the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) were enrolled between June 2018 to October 2019, and they were randomly divided into observation group and control group with 45 cases in each group. Patients in the control group received telephone follow-up while "internet +" disease management based on the AISAS model was applied in the observation group. The drug therapy compliance, acquisition of the disease knowledge, quality of life, anxiety and depression levels, return to workand incidence of cardiovascular events.Results:One year after the intervention, the drug therapy compliance score, disease-related knowledge score, quality of life score, SAS and SDS scores of the observation group were 7.55±1.21, 7.29±1.27, 701.17±74.86, 32.55± 4.31, 34.74±4.16, the scores of patients in the control group were 6.48±1.56, 6.12±1.94, 670.58±65.29, 41.72±4.33, 40.79±4.17. The difference was statistically significant ( t value was 2.066-11.203, P<0.05). The comparison between the return of the patients and the incidence of cardiovascular events in the two groups was statistically significant ( χ2 value was 5.031, 11.275, P<0.05). Conclusion:This management model can increase the knowledge of disease PCI postoperative patients, improve their quality of life, make patients return to society earlier, and promote the improvement of the quality of continuous nursing service.

Objective: To verify the costs, benefit and effectiveness of hepatitis B immunoprophylaxis strategies in Shenzhen during 2006-2030. Methods: The markov model was constructed to reflect the reality of the newborn vaccination and prevention of mother to child transmission (PMTCT) strategy, the cost, benefit and effectiveness during 2006-2015 and 2016-2030 was evaluated and predicted by the model. The model was constructed with the basic parameters such as the positive rate of hepatitis B surface antibody, perinatal HBV infection rate, the screening rate and positive rate of HBsAg of pregnant women, the utility value of hepatitis B and the parameters of markov model. and the coverage rates, vaccination fee of hepatitis B and the expenditures of patients with HB-related diseases.The costs were calculated from the payer, medical-care and all society perspective. The effectiveness and benefits of the strategy were evaluated and predicted by the numbers of HBV infection and the patients with HBV-related diseases prevented, life years (LYs), quality adjusted life years (QALYs), the net benefits (NBs) and benefit cost ratio (BCRs). Results: From the payer, medical-care and all society perspectives, the costs for the strategy were 153 million Yuan, 5.51 billion Yuan and 10.92 billion Yuan, respectively from 2006 to 2030 of which the forecast costs for 2016-2030 were 120 million Yuan, 3.87 billion yuan and 7.81 billion yuan. During the year 2006-2030, the numbers of HBV infection and the HBV-related diseases was 2.48 million, more than 1.335 million LYs and 1.619 million QALYs should be obtained from the strategy implemented. From medical-care and all society perspectives, NBs should be 88.68 billion yuan and 150.13 billion yuan with the BCRs of 17.08 and 14.75, respectively. Particularly, the NBs value of 22.37 billion yuan and 37.98 billion yuan and the BCR value of 14.62 and 13.20 was calculated for the past period, but the future NBs of 66.31 billion yuan and 112.15 billion yuan and BCR of 18.12 and 15.36 in the year 2016-2030. The further benefits were increased evidently in the future. Conclusion The hepatitis B immunization in Shenzhen has a high economic effectivenee and benefits, and it is worth to invest sustainably.