Objective:To estimate the safety and feasibility of flexible laryngeal mask airway (FLMA) for lumbar vertebral surgery in prone position.Methods: In the study,120 adult patients scheduled for lumbar vertebral surgery under intravenous general anesthesia were divided into group FLMA and reinforced tracheal tube (RTT) group at random.Heart rate (HR),systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded at the beginning of anesthesia induction (T0) and on the time of artificial airway intubation (T1),1 min after intubation (T2),extubation (T3),1 min after extubation (T4) as well.The number and time required for intubation were recorded.Peak airway pressure (PPEAK),airway sealing pressure (PAS) in group FLMA and fiberoptic bronchoscopy scale (FBS) were recorded after artificial airway intubation,turned over into prone position and after the operation started,as well as on the time of 1 hour after the operation started,2 hours after operation started and when the operation stopped.Finally,respiratory complications after extubation,including hypoxemia,laryngospasm,coughing,vomiting,hoarseness,and pharyngalgia,were observed and whether there was blood or sewage inside and outside the artificial airway was recorded.Results: There was no difference in the number and time required for intubation between the two groups (P>0.05).There was no difference in PPEAK and FBS between the two groups,and also the same at the different time points in each group (P>0.05).PAS in group FLMA was the same at the diverse time points during anesthesia (P>0.05) and always higher than PPEAK in the perioperative period.In group FLMA,there was no difference in HR,SBP and DBP between the time points of T2 and T1,also of T4 and T3 (P>0.05).In group RTT,HR,SBP and DBP were significantly higher between the time points of T2 and T1 (P<0.01);SBP was significantly higher between the time points of T4 and T3 (P<0.01),DBP and HR were higher between the time points of T4 and T3 (P<0.05).SBP in group FLMA was significantly lower than in group RTT at T2 (P<0.01),HR and DBP were lower than those in group RTT simultaneously (P<0.05).On the time point of T4,SBP,DBP and HR in group FLMA were lower than those in group RTT (P<0.05).The incidence of coughing and pharyngalgia after extubation was significantly lower in group FLMA than in group RTT (P<0.01),with the incidence of hoarseness was lower in group FLMA than in group RTT (P<0.05).There was no difference in the incidence of hypoxemia,vomiting and blood seen outside the cuff between the two groups (P>0.05) while no laryngospasm and sewage seen outside the artificial airway in each group.Conclusion: For suitable patients,FLMA can be used in mechanical ventilation forlumbar vertebral surgery in prone position with more stable circulation and less respiratory complications than RTT.Further clinical validation is needed for the safety of FLMA.

Objective To explore the role of cell proliferation and apoptosis, and the expression significance of involved protein as Bcl-2(B-cell lymphoma/leukemia-2) and Bax (Bcl-associate X protein) in the developing small intestine of human fetus. Methods The expression product of Bcl-2 and Bax was investigated with immunohistochemical methods in the 2nd, 3rd and 4th months of gestation respectively. Results In the second, the third and the fourth month of gestation, the Bcl-2 immunoreactive positive signals were found in the ganglion cells of intermuscular and submucous nerve plexus. Bax positive cells were observed in the cytoplasm of the simple columnar epithelium cells of the small intestinal mucous layer.Conclusion Bcl-2 and Bax proteins regulate the developing small intestine of human fetus.

Objective:To report a rare case of renal injury secondary to Strongyloides stercoralis infection, and investigate common pathological subtypes, pathogenesis and differential diagnosis of Strongyloides stercoralis infection-associated renal injury combined with literature. Methods:The pathological features of renal biopsy were analyzed by immunofloruscence, light microscope and electronic microscope. The pathological changes of digestive tract and pathogen morphology were observed through endoscope and digestive tract biopsy. The correlation between clinical-pathological features and pathological changes of kidney and digestive tract was analized.Results:The 26-year-old male patient presented with nephrotic syndrome. The pathological changes of renal biopsy were consistent with minimal change disease with interstitial focal eosinophil infiltration. Laboratory examination showed that the patient had unexplained eosinophilia and increased IgE level. Hence the patient was treated with glucocorticoid. After 2 months of therapy, proteinuria decreased and turned to negative while the patient developed progressive headache, gastrointestinal bleeding and progressive decrease of hemoglobin. Emergency gastroscopy showed extensive congestion and erosion of the stomach and duodenum. Gastric mucosal biopsy showed a large number of slender "s" shape larvae in the mucosa. The patient also had bilateral lung infection, positive Escherichia coli in cerebrospinal fluid and purplish skin rash around the umbilicus. A serious infection of Strongyloides stercoralis was diagnosed. After antibiotics and anthelmintic treatment, gastrointestinal symptoms and headache disappeared, and no parasite was found in endoscopy. No recurrence of nephrotic syndrome was found during 2 years of follow-up. Conclusions:Strongyloides stercoralis infection might first present with nephrotic syndrome with handful hints of digestive tract combined with eosinophilia and increased IgE levels. Therefore, in epidemic areas or patients with suspicious exposure history, it is necessary to exclude Strongyloides stercoralis infection before immunosuppressive therapy to avoid fatal complications.

BACKGROUND:IPS e.max Presshas an excelent biocompati bility and corrosion resistance, which obtains satisfactory clinical outcomes on dental veneers, inlay and onlay restorations. But little is reported on molar monolithic restoration by IPS e.max Presscrown.
OBJECTIVE:To evaluate the clinical effects of IPS e.max Press crown on molar repair after root canal therapy.
METHODS:Totaly 215 patients with 324 affected molars, including 88 males and 127 females, aged 22-58 years old, were enroled for repairing with IPS e.max Presscrown. Then the color, shape, fracture and edge coloring of the restoration, marginal discrepancy, secondary caries and gingival health status were assessed after a 3-year folow-up.
RESULTS AND CONCLUSION:During the folow-up, 324 dental restorations met the class A standards for color, marginal discrepancy, shape as wel as secondary caries. In addition,3restoration swere fractured, 14 restorations had margin coloring, and 8 restorations appeared to have gingival inflammation. More than 95% restorations were scored grade A. These results indicate that IPS e.max Press crown applied to molar repair after root canal therapy can achieve ideal outcomes.

Objective:To explore the association between chest high resolution CT (HRCT) scoring and prognostic factors of interstitial lung disease (ILD) in patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (DM).Methods:The patients with DM admitted to Kailuan General Hospital between January 2017 and December 2019 were included into the study including 13 patients with positiveanti-MDA5 antibody (7 survivors, 6 deaths) and 18 patients with anti-synthase (ARS)-antibody positive. All patients underwent chest HRCT prior to treatment. The consolidation, ground-glass opacity (GGO) and fibrosis were scored to assess HRCT findings. The clinical manifestations were compared between the two groups. Cox regression analysis adjusted for age and sex was used to determine the prognostic factors for anti-MDA5 antibody-related ILD.Results:Compared with ARS patients, glutamyl transferase (GGT) and ferritin levels were significantly higher in MDA5-ILD patients [70.0(37.0, 122.5) vs 21.0(16.5, 33.5), Z=-3.37, P=0.001; 977.0(502.5, 1 366.0) vs 307.1(72.3, 546.9) , Z=-3.44, P=0.001]. The cumulative survival rate was significantly lower in patients with positive anti-MDA5 antibody than in those with positive anti-ARS antibody (100% vs 70%, P=0.001). The DM complicated with acute/subacute interstitial pneumonia (A/SIP) were found to significantly relate to death. There were no significant differences in chest HRCT scoringbetween the survivors and the deceased patients [ HR=1.08, 95% CI(0.95, 1.23), P=0.229; HR=0.97, 95% CI(0.72, 1.30), P=0.814]. Conclusion:Anti-MDA5 antibody is an important index for early diagnosis of DM complicated with acute/subacute interstitial pneumonia (A/SIP). The chest HRCT scoreis is not associated with the prognosis of anti-MDA5 antibody-related ILD patients.

OBJECTIVEThe effect of the gene polymorphism for the key enzyme's folacin metabolism pathway on plasmatic homocysteine (Hcy) levels in fertile woman was observed.

METHODSThe subjects were from Shaoxing City, Jiangsu province in 2012, the selection criteria for the women of childbearing age were between 20-45 years old, with an average age of 28.2 (95%CI:27.8-28.6) years old. Sample collection continued uninterrupted lasted seven days, a total of 535 samples were collected, venous blood with EDTA addition or sodium citrate to anticoagulant. After separation, the blood cells and blood plasma were cryopreserved. DNA was extracted using spin column method. All the samples were selected for the gene polymorphism testing of the key enzyme's on folate metabolism and monitoring of plasmatic Hcy level.

RESULTSEight single nucleotide polymorphism (SNP) sites of methylenetetrahydrofolate reductase gene (MTHFR) , methionine synthase gene (MS) , synthetic methionine reductase gene (MSR) and cystathionine β synthase gene (CBS) were detected. It was found the genotype AA of the SNP sites-rs1801131 would result higher plasmatic Hcy levels (8.99 µmol/L) than the genotypes CC (7.81 µmol/L) and CA(8.38 µmol/L) (P < 0.01) . Similarly, the genotype TT of the SNP sites-rs1801133 was significantly responded to the increasing of Hcy levels (11.10 µmol/L) than the genotype CC (8.15 µmol/L) and CT (8.45 µmol/L), (P < 0.01) . The two sites of genotype combination of AA-TT could also result in the significant increase of Hcy levels (11.02 µmol/L) than other combined genotypes (genotypes CC-CC, CA-CC, CA-CT, AA-CC, AA-CT), especially the genotype CC-CC. And the risk factor was 1.41 (95CI:1.20-1.66) times over the genotype CC-CC.

CONCLUSIONThe gene mutations of two SNP sites rs1801131 and rs1801133 in MTHFR would increase Hcy levels.

5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase ; genetics ; Adult ; China ; Cystathionine beta-Synthase ; genetics ; Female ; Ferredoxin-NADP Reductase ; genetics ; Folic Acid ; Genotype ; Homocysteine ; blood ; genetics ; Humans ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Mutation ; physiology ; Polymorphism, Single Nucleotide ; Risk Factors

Objective To investigate the relationship between serum uric acid ( UA) level and brachial?ankle pulse wave velocity ( baPWV) in patients with systemic lupus erythematosus ( SLE) and lupus nephritis (LN)??Methods A total of 110 hospitalized,out?patient and healthy examinees from January 2017 to September 2017 were selected from Kailuan General Hospital??They were divided into three groups:(1)Fifty?five healthy controls were examined at the same time,and those who had no history of hypertension, myocardial infarction and stroke were excluded by physical examination??(2)Thirty?four SLE patients without LN were diagnosed according to the SLE classification standard revised by the American Society of Rheumatology ( ACR) in 1997,excluding those with lupus nephritis??( 3) 21 SLE patients with LN were diagnosed according to the SLE classification standard revised by the American Society of Rheumatology (ACR) in 1997??Pearson correlation coefficient and multivariate linear regression model were used to analyze the related factors affecting baPWV??Results The level of baPWV and the proportion of baPWV (≥1400 cm／s) in SLE without LN group and SLE with LN group were higher than those in healthy control group (all P＜0??05)??In SLE without LN group, baPWV was positively correlated with age, systolic blood pressure (SBP) and total cholesterol ( CHOL) ( r＝ 0??623,0??528,0??402, P＜0??01 or P＜0??05), and negatively correlated with blood uric acid(UA) ( r＝－0??371,P＜0??05),but the correlation was not significant??The correlation between UA and baPWV disappeared after after correction of age,SBP,diastolic blood pressure (DBP) by partial correlation analysis??In SLE with LN group,baPWV was positively correlated with SBP, DBP and serum creatinine ( Cr) ( r＝0??815, 0??725, 0??464, P＜0??01 or P＜0??05)??Multivariate stepwise regression analysis showed that SBP was independently correlated with baPWV in SLE group ( t＝2??54,P＝0??026); UA in SLE group without LN was independently negatively correlated with baPWV(t＝－2??96,P＝0??042); UA(t＝4??24,P＝0??013) and SBP(t＝7??70,P＝0??002) were independently positively correlated with baPWV in SLE group with LN??Logistic regression analysis showed that SLE was a risk factor for baPWV (≥1 400 cm／s),and the OR (95% CI) was 4??31 ( 1??56－11??88),P＝0??005,and there was statistical significance after adjusting for age,SBP,DBP,body mass index ( BMI)??However,UA was not a risk factor for baPWV (≥1 400 cm／s) (P values were 0??163 and 0??519,respectively)??Conclusion The degree of arteriosclerosis in SLE patients is higher than that in normal subjects,and the level of UA in SLE patients may be related to baPWV??

Objective:To analyze the quality control test results of urine fluoride laboratories in Jiangxi Province, and support reliable data for the monitoring and prevention of fluorosis.Methods:From 2019 to 2021, the Jiangxi provincial urine fluoride laboratories used the "Determination of Fluoride in Urine-Ion Selective Electrode Method" (WS/T 89-2015) to detect quality control samples. Origin 9 software was used to analyze the data, and Youden plots and deviation bar plots were produced. The results were evaluated based on the Z-score (qualified: │Z│ ≤2, basically qualified: 2 < │Z│ < 3, unqualified: │Z│ ≥3).Results:The qualified rate of quality control assessment results of urine fluoride laboratories in Jiangxi Province was 95.00% (38/40) . Most of urine fluoride laboratories had scores of │Z│ < 2, and two laboratories had scores │Z│≥3 in 2019 and 2020.Conclusion:The quality control assessment results of urine fluoride laboratories in Jiangxi Province are relatively satisfactory, but some laboratories still need to further improve their detection capabilities.

Objective To discuss the necessity and feasibility of application of virtual reality (VR) technology in the teaching course of radiotherapy technology based on the contradictions between the theory and practice of current teaching mode.Methods After in-depth analysis of the characteristics of the existing disciplinary teaching mode,VR technology was introduced to design software,glasses,operating handles and establish a special interactive platform. The teaching courses could be delivered via mobile phone side AR, helmet and AR, touch screen and PC virtual simulation with VR virtual simulation, etc. Six processes of radiotherapy were tested through online courses and offline groups to analyze the feasibility of this technology applied in the training of radiotherapy professionals. Results After the design of software and hardware and the analysis of test results,the online teaching could be utilized to write interactive programs,build virtual experience scenes, create course resource database and construct practical training courses and teaching system. The offline practice test could be applied to the simulation learning of feedback of the whole process, which possessed feasibility and development value. It could be applied to the theory and practice teaching of radiation therapy technology,making the teaching more convenient,vivid and intuitive. Conclusions VR technique combined with radiotherapy technology training can be delivered through online and offline teaching courses of theory and practice by using the plane and virtual simulation technology, which is convenient, quick and highly efficient and deserves widespread application.

Objective:To analyze the results of external quality control network of iodine deficiency disorders (IDD) laboratories in Jiangxi Province in 2018, to summarize the total detection level and capability at all levels, and to provide reliable quality assurance for monitoring and prevention of IDD.Methods:In 2018, IDD laboratories of provincial, municipal and county-level in Jiangxi Province were examined for the external quality control of salt iodine, urinary iodine and water iodine. Among them, there were 1 provincial, 11 municipal and 30 county-level laboratories participated in salt iodine assessment; there were 1 provincial, 11 municipal and 100 county-level laboratories participated in urinary iodine assessment; and there were 1 provincial and 11 municipal laboratories participated in water iodine assessment. Salt iodine was determined by direct titration method (GB/T 13025.7-2012); urinary iodine was determined by As 3+-Ce 4+ catalytic spectrophotometry method (WS/T 107.1-2016) or inductively coupled plasma mass spectrometry method (WS/T 107.2-2016); water iodine was determined by the method in the range of 0 - 100 μg/L in "Study on the Method Suitable for the Detection of Water Iodine in Areas with Iodine Deficiency and High Iodine" recommended by national IDD reference laboratory. Urinary iodine was determined with Z score method, when│Z│≤ 2, it was qualified; when 2 <│Z│ < 3, it was basically qualified; when│Z│≥ 3, it was not qualified. Water iodine and salt iodine were determined by the method of reference value ± uncertainty, and the average value of the test results within this range was judged to be qualified; otherwise, it was judged to be unqualified. Results:In 2018, the feedback rates and qualified rates of salt iodine, urinary iodine and water iodine in 1 provincial and 11 municipal laboratories in Jiangxi Province were all 100.00%. Thirty county-level laboratories participated in the salt iodine assessment, and 1 of them failed. One hundred county-level laboratories participated in the urinary iodine assessment, and 3 of them failed.Conclusion:Laboratory testing technology of IDD continues to maintain at a high level in Jiangxi Province in 2018, and the detection ability of some county-level laboratories needs to be further improved.