OBJECTIVETo explore the impact of titanium implant on the growth and development of pediatric mandible after suffering from mandibular fracture and undergoing open reduction and internal fixation (ORIF) compared with those that underwent titanium plate removal postoperatively.

METHODSFifteen pediatric patients with mandibular fracture who underwent ORIF were included in this study. Eight patients did not undergo titanium implant removal postoperatively, whereas the other seven patients underwent the routine. The postoperative data of the pediatrics were collected for comparative analysis by taking the patients' frontal and lateral photos, recording the inter-incisor distance, and measuring the height of mandibular ramus, length of the mandibular body, and combined length of the mandible in three-dimensional reconstruction image.

RESULTSAll patients had acceptable facial contour, mouth opening, and occlusion, without obvious abnormalities. The radiography showed no significant difference between the bilateral mandibular lengths in the two groups of patients (P>0.05).

CONCLUSIONThe titanium plants have no significant impact on the growth and development of pediatric mandible postoperatively; hence, the question on whether the titanium plates should be removed or not may be neglected. The removal operation may lead to secondary trauma; thus, performing titanium plate removal routinely is not recommended.

Bone Plates ; Dental Implants ; Dental Occlusion ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Mandible ; Mandibular Fractures ; Prostheses and Implants ; Time Factors ; Titanium

Objective To investigate the effect of Candida albicans and its components on the expression level of human beta-defensin-2 mRNA (HBD-2) in keratinocytes in vitro. Methods Different components of Candida albicans were isolated by lyticase, repeated freezing and thawing, sonication, and centrifugation. The keratinocytes and HaCaT cell lines were co-cultured with Candida albicans and its cellular components for 24 h. The expression level of HBD-2 mRNA was detected by reverse-transcription polymerase chain reaction (RT-PCR). Results Low expression level of HBD-2 mRNA in the unstimulated keratinocytes and HaCaT cells was detected. The HBD-2 mRNA expression levels in the keratinocytes stimulated by Candida albicans, the extract of its cell wall, and pure mannan were significantly increased (P 0.05). Conclusions Candida albicans, the extract of cell wall of Candida albicans, and commercial mannan can increase the expression level of HBD-2 mRNA in keratinocytes.

Objective To investigate the mechanism by which Nicotinamide adenine dinucleotide(NADH)regu-lates anti-tuberculosis drug-induced liver injury and apoptosis in mice through SIRT1/Nrf2 pathway.Methods Twenty-four six-week-old SPF male mice were randomly divided into four groups according to body weight,ADLI group[90 mg/(kg·d)Isoniazid,135 mg/(kg·d)Rifampicin,315 mg/(kg·d)Pyrazinamide were given by gavage],control group[thesame volume of saline was given by gavage as antituberculosis drug-induced liver injury(ADLI)group],NADH group(30 mg/kg NADH wasgiven by gavage on the basis of control group)and NADH intervention group(30 mg/kg NADH wasgiven by gavage on the basis of ADLI group),with sixmice in each group.They were gavaged continuously for seven days,and their seruand liver tissues were collected.The mRNA and protein expression of silence information regulator 1(SIRT1),nuclear factor erythroid 2-related factor 2(Nrf2)in SIRT1/Nrf2 pathway,apoptosis indicators B-cell lymphoma-2(Bcl-2),Bcl-2-associated X protein(Bax)and caspase-3 were detected by qRT-PCR and Western blot,respectively.HE staining was performed to observe the morphology of liver tissue.The liver was weighedandthe liver index was obtained by dividingweight by body weight.The levels of glutamate aminotransferase(ALT),aspartate aminotransferase(AST)and lactate dehydrogenase(LDH),which are indicators of liver injury,were detected by microplate method.Results Compared with control group,the protein and mRNA expression of SIRT1,Nrf2decreased significantly in ADLI group.Liver tissue struc-ture wasdisturbed,hepatocytes were obviously swollen,and their boundary was unclear.The weight of mice de-creased,but liver index increased.The mRNA and protein expression level of anti-apoptotic factor Bcl-2 decreased,while that of Bax and caspase-3 was raised.The level of ALT,AST and LDH were also elevated.The differences a-bove were statistically significant(P＜0.05).Compared with ADLI group,the protein and mRNA expression of SIRT1,Nrf2 were higher after NADH intervention.Liver tissue structure became clear,and hepatocytes were po-lygonal.The protein and mRNA expression of anti-apoptosis factor Bcl-2 was elevated and while that of Bax and caspase-3 was lower.The weight of mice increased and liver index decreased.The expression of ALT,AST and LDH decreased.The differences above were statistically significant(P＜0.05).Conclusion NADH may allevi-ate anti-tuberculosis drug-induced liver injury and apoptosis in mice by regulating SIRT1/Nrf2 pathway.

Objective:To investigate the effect of human Cu/Zn superoxide dismutase (hSOD1) gene with G93A mutation on Nrf2/ARE signaling pathway in NSC‐34 cell ,the transgenic cell model of amyotrophic lateral sclerosis (ALS) .Methods :The established plasmids ,hSOD1‐pcDNA3 .1(‐) ,hSOD1‐G93A‐pcDNA3 .1(‐) ,and pcDNA3 .1(‐) were transfected into NSC‐34 cells ,the transgenic cell model of amyotrophic lateral sclerosis .The models were divided into four groups according to different transfected plasmids .They were normal group ,empty group ,wild group and mutation group .The oxidative‐stress injury was evaluated by detecting the content of intracellular malondialdehyde (MDA) ,a lipid peroxidation product .The permeability of mitochondrial membrane was detected .Western blotting was used to determine the intracellular protein expression level of Nrf 2 and antioxidase ,so as to reveal the activation level of the Nrf2/‐ARE signaling pathway in each group .Results:The level of oxidative stress and the mitochondrial permeability increased in the NSC‐34 cells transfected with human hSOD1‐G93A‐pcDNA3 .1(‐) gene(mutation group ,P<0 .05) ,which implied impairment of mitochondrias .The protein expression level of Nrf2 ,significantly decreased in NSC‐34 cells transfected with hSOD1‐G93A gene(P< 0 .05) .So were heme oxygenase‐1 (HO‐1) and NAD(P)H :quinone oxidoreductase 1 (NQO1) ,downstream effector molecules of Nrf2‐ARE signaling pathway . The expression of Nrf 2 in cytoplasm significantly decreased in mutation group , while Nrf2 expression in cell nucleus significantly increased (P<0 .05) in mutation group and wild group ,especially in mutation group (P<0 .05) .Conclusions :The G93A mutation of hSOD1 gene impairs Nrf2/ARE signaling pathway in ALS cell models ,reduces the antioxidant ability of cells ,and increase the impairment of mitochondrias .

Objective:To investigate the clinical characteristics and prognosis of idiopathic inflammatory myopathy (IIM) patients with positive anti-melanoma differentiation-associated gene 5 (MDA5) antibody.Methods:A total of 194 hospitalized IIM patients who were tested for myositis-specific autoantibodies (MSAs) in the Departments of Rheumatology and Immunology of Tianjin Medical University General Hospital from January 2015 to September 2020 were collected, including 29 cases with positive anti-MDA5 antibody and 165 cases with negative anti-MDA5 antibody. Their clinical data were analyzed retrospectively. T test was used for measurement data with normal distribution. Measurement data with non-normal distribution were tested by Mann-Whitney U rank sum test. χ2 test was used for counting data. Risk factors were analyzed by binary Logistic regression, survival analysis by Kaplan-Meier method and Cox regression analysis. Results:IIM patients with positive anti-MDA5 antibody had a high incidence of dermatomyositis specific skin rash, and the skin rash was the most common presenting symptom. In the positive anti-MDA5 antibody group, muscle symptoms were mild; and the patients were prone to have fever, arthritis, oral ulcer and weight loss. All patients were complicated with interstitial lung disease (ILD). In patients with negative anti-MDA5 antibody, white blood cell (WBC) count [7.59(5.61, 9.89)×10 9/L vs 4.07(3.17, 5.50×10 9/L, Z=-5.05, P<0.001], platelet (PLT) [249.00 (200.00, 302.00)×10 9/L vs 205.00 (178.00, 244.00)×10 9/L, Z=-2.59, P=0.010], lymphocyte (LY) [1.34(0.85, 1.94)×10 9/L vs 0.64(0.40, 0.83)×10 9/L, Z=-5.78, P<0.001), serum creatine kinase (CK) [558.00 (72.00, 2 959.00) U/L vs 64.00 (35.00, 149.50) U/L, Z=-3.97, P<0.001], creatine kinase isoenzymes (CK-MB) [38.00 (17.00, 127.00) U/L vs 16.00 (14.00, 25.00) U/L, Z=-3.84, P<0.001], myoglobin (MYO) [243.65 (60.50, 829.83) ng/ml vs 34.55(21.00, 104.23) ng/ml, Z=-3.98, P<0.001], troponin T (TnT) [0.09(0.03, 0.44) ng/ml vs 0.02(0.01, 0.04) ng/ml, Z=-4.17, P<0.001], albumin (ALB) [34.00(30.00, 38.00) g/L vs 31.00 (26.50, 36.00) g/L, Z=-2.68, P=0.007], cluster of differentiation 4 (CD4) + T cells [498.00(276.00, 752.00) cells/μl vs 259.50 (179.00, 498.25) cells/μl, Z=-2.79, P=0.005], partial pressure of carbon dioxide (PaCO 2) [39.00(36.13, 42.00) mmHg vs 35.35 (31.30, 38.88) mmHg, Z=-3.75, P<0.001], partial pressure of oxygen (PaO 2) [82.00(71.90, 90.20) mmHg vs 73.25(64.30, 84.05) mmHg, Z=-2.08, P=0.037], arterial oxygen saturation (SaO 2) [96.50% (95.05%, 97.30)% vs 95.80%(93.70%, 96.55%), Z=-2.11, P=0.035], diffusion capacity for carbon monoxide of the Lung (DLco) [(63±21) % vs (52±14)%, t=0.96, P=0.006] were significantly reduced, while UTP [260.50 (172.25, 401.25) g vs 331.00 (252.75, 666.25) g, Z=-2.18, P=0.029], alanine aminotransferase (ALT) [40.00 (21.00, 83.00) U/L vs 56.00(40.00, 107.50), Z=-2.27, P=0.023], glutamyltranspeptidas (GGT) [22.50(15.00, 42.00) U/L vs 57.00 (38.00, 101.50) U/L, Z=-4.98, P<0.001], D-Dimer [850.00 (485.00, 1 799.50) ng/ml vs 1 346.00 (896.50, 2 527.00) ng/ml, Z=-2.55, P=0.011], immunoglobulin (Ig)E [60.00 (25.60, 147.50) U/ml vs 173.00(68.25, 471.50) U/ml, Z=-3.06, P=0.002], C4[20.25(16.68, 25.03) mg/L vs 23.60(20.20, 28.35) mg/L, Z=-2.38, P=0.017], Fer [228.01 (115.40, 513.36) ng/ml vs 1 636.39 (851.80, 3 888.82) ng/ml, Z=-6.01, P<0.001], krebsvondenlungen-6 (KL-6) [365.00 (180.25, 1 018.75) U/ml vs 788.00 (406.00, 1 364.00) U/ml, Z=-2.10, P=0.035] were higher when compared to patients with positive anti-MDA5 antibody. In the anti-MDA5 antibody positive group, patients had high mortality rate [8.5%(14/165) vs 34.5%(10/29), χ2=13.07, P<0.001], and the use of intravenous immunoglobulin [32.7%(54/165) vs 65.5%(19/29), χ2=11.30, P=0.001] and steroid pulse therapy [4.8%(86/165) vs 27.6%(8/29), χ2=13.98, P<0.001] were more frequent. Patients in the positive anti-MDA5 antibody group were classified into two sub groups based on lung features: the rapidly progressive interstitial lung disease (RP-ILD) group (48.28%, 14/29) and the chronic interstitial lung disease (C-ILD) group (51.72%, 15/29). RP-ILD patients had significantly elder disease onset age, higher C-reaction protein (CRP), Fer, IgE levels and the positive rate of anti-Ro52 antibody, while ALT was lower. The difference was statistically significant. Regression analysis suggested that older onset age [ HR (95% CI)=1.154 (1.069, 1.246), P<0.001], male [ HR(95% CI)=6.383(1.038, 39.242), P=0.045], positive anti-MDA5 antibody [ HR(95% CI)=17.180 (2.900, 101.766), P=0.002], LY decrease [ HR (95% CI)=0.083 (0.008, 0.817), P=0.033], high serum Fer level [ HR (95% CI)=1.001(1.000, 1.001), P=0.016], increased D-Dimer [ HR(95% CI)=1.000(1.000, 1.001), P=0.004] and compicated with carcinoma [ HR (95% CI)=11.849 (1.978, 70.970), P=0.007] were independent risk factors for death in IIM patients. Binary logistic regression analysis suggested that late onset age [ OR(95% CI)=1.090 (1.005, 1.183), P=0.038], high Fer level [ OR (95% CI)=1.001 (1.000, 1.001), P=0.022] and decreased ALB [ OR (95% CI)=0.818 (0.696, 0.963), P=0.016] might be risk factors for RP-ILD in patients with positive anti-MDA5 antibody. Conclusion:In patients with positive anti-MDA5 antibody group, typical skin damage, mild muscle symptoms, high proportion of ILD and poor prognosis are chardcteristic when compared to patients without this autoantibody. It is necessary to monitor the disease activity closely and explore the treatment strategy.

Objective To analyze the clinical features of microscopic polyangiitis(MPA)-associated interstitial lung disease(ILD)patients infected with coronavirus disease-2019(COVID-19),and investigate the protective effect of SARS-CoV-2 vaccine.Methods Patients with MPA-ILD in the General Hospital of Tianjin Medical University were included,and patients also met the diagnostic criteria for COVID-19 in accordance with the COVID-19′s diagnosis and treatment plan(10th Edition).All of patients had positive evidence of coronavirus antigens or positive nucleic acid tests.Clinical data of patients,ILD imaging typing,COVID-19 vaccination,clinical typing and prognostic results were collected and analyzed.Results Thirty-seven patients with MPA-ILD were included,including 14 females and 23 males.Thirty-two patients with MPA were in remission at the time of infection with COVID-19,and 31 were maintained on concurrent immunosuppressive/biologic therapy.The original imaging type of MPA-ILD was predominantly usual interstitial pneumonia(UIP,15 cases)and nonspecific interstitial pneumonia(NSIP,14 cases).The typing of the remaining 8 cases was inconclusive.Of the COVID-19 subtypes,27 patients were mild infection,and 5 dead due to COVID-19.Eleven patients were unvaccinated,and 26 received inactivated vaccine.Among them,11 completed 3-dose of booster immunization.The proportion of patients with mild COVID-19 was significantly higher in MPA-ILD patients with vaccinated patient group than that in the unvaccinated patient group(P=0.038).Multifactorial analysis showed that vaccines were an independent protective factor for MPA-ILD patients with COVID-19 infection(OR=0.045,95%CI:0.004-0.472,P=0.010)and non-mild infection(OR=0.049,95%CI:0.005-0.517,P=0.012).Moreover,MPA in remission was a protective factor for COVID-19 non-mild infections(OR=0.021,95%CI:0.001-0.459,P=0.014).Conclusion Vaccination and MPA in remission may reduce the severity of COVID-19 infection in patients with MPA.

Objective:To explore the clinical characteristics of pediatric kidney transplant recipients reinfected with SARS-CoV-2.Method:The relevant clinical data were retrospectively reviewed for 191 pediatric kidney transplant recipients at a single center. Based upon whether or not there was a reinfection of SARS-CoV-2, they were assigned into two groups of single infection (group A, 127 cases) and reinfection (group B, 64 cases). Baseline profiles, clinical symptoms, diagnostic and therapeutic strategies, markers of disease progression, immune status, respiratory support modalities, comorbidities and transplantation-related data were collected for comparing the inter-group differences during primary infection and between two infections in reinfected group.Result:As compared with group A, group B recipients had a higher proportion of age <12 years (71.9% vs 54.3%) ,unvaccinated (81.2% vs 66.1%) and such symptoms as high fever (34.4% vs 12.6% ), dry cough (43.8% vs 23.6% ) and chest tightness (14.1% vs 3.9 %) during primary infection (all P<0.05). During primary infection, the levels of IL-6 and CRP were higher in group B than in group A and inter-group difference was statistically significant (both P<0.01). The levels of IL-6 ( P<0.01), CRP ( P<0.01) and PCT ( P= 0.023) were lower in group B during reinfection than those during primary infection and the difference was statistically significant. During primary infection, the counts of CD3+, CD4+, CD8+, NK and B lymphocyte of group B were lower than those of group A. And inter-group differences were statistically significant (all P<0.01). During reinfection, the levels of CD3+, CD4+, CD8+, NK and B lymphocyte counts of group B spiked as compared with those of group A during primary infection and the differences were statistically significant (all P<0.01). The levels of SCr and UA in group B differed insignificantly before and after primary infection with SARS-CoV-2. However, the differences before and after reinfection were statistically significant (both P<0.01) . Conclusion:Symptomatic and immunocompromised pediatric KT recipients during primary infection with SARS-CoV-2 are more prone to reinfection during subsequent epidemics. Though mildly symptomatic, reinfection may exacerbate impairments of graft kidney function in pediatric KT recipients.

Objective??To?explore?the?impact?of?titanium?implant?on?the?growth?and?development?of?pediatric?mandible?after?suffering?from?mandibular?fracture?and?undergoing?open?reduction?and?internal?fixation?(ORIF)?compared?with?those?that?underwent?titanium?plate?removal?postoperatively. Methods??Fifteen?pediatric?patients?with?mandibular?fracture?who?underwent?ORIF?were?included?in?this?study.?Eight?patients?did?not?undergo?titanium?implant?removal?postoperatively,?whereas?the?other?seven?patients?underwent?the?routine.?The?postoperative?data?of?the?pediatrics?were?collected?for?comparative?analysis?by?taking?the?patients’?frontal?and?lateral?photos,?recording?the?inter-incisor?distance,?and?measuring?the?height?of?mandibular?ramus,?length?of?the?mandibular?body,?and?combined?length?of?the?mandible?in?three-dimensional?reconstruction?image.?Results?All?patients?had?acceptable?facial?contour,?mouth?opening,?and?occlusion,?without?obvious?abnormalities.?The?radiography?showed?no?significant?difference?between?the?bilateral?mandibular?lengths?in?the?two?groups?of?patients?(P>0.05).?Conclusion?The?titanium?plants?have?no?significant?impact?on?the?growth?and?development?of?pediatric?mandible?postoperatively;?hence,?the?question?on?whether?the?titanium?plates?should?be?removed?or?not?may?be?neglected.?The?removal?operation?may?lead?to?secondary?trauma;?thus,?performing?titanium?plate?removal?routinely?is?not?recommended.

Objective To investigate the nutritional status and dietary structure of tuberculosis patients among dif-ferent populations, analyze the factors influencing the nutritional status of tuberculosis patients, and provide theo-retical basis for improving clinical nutrition and related issues in tuberculosis patients.Methods Tuberculosis pa-tients, non-tuberculosis patients, and healthy individuals were randomly selected for a questionnaire survey.De-scriptive analysis was conducted using SPSS 20.0 software.Statistical description was performed using rates and composition ratios, and qualitative data were described using relative numbers.Chi-square test was used to compare overall rates and composition ratios among different health conditions groups, with a significance level of α=0.05.Independent factors analysis of nutritional status body mass index (BMI) was conducted using multiple Logistic re-gression analysis for variables with statistically significant differences in the univariate analysis.Results There were differences in the nutritional status (x2 =62.184, P<0.05) and dietary diversity score (x2 =64.049, P<0.05) among tuberculosis patients, non-tuberculosis patients, and healthy individuals.Univariate analysis of nutri-tional status BMI showed statistically significant differences in gender, smoking, meat-based diet, vegetable-based diet, moderate diet diversity score, and 6 other variables for tuberculosis patients (P <0.05) , and in gender, age, ethnicity, marital status, occupation, education level, smoking, drinking white wine, drinking beer, meat-based diet, moderate diet, and 11 other variables for healthy individuals (P<0.05) .The variables with statisti-cally significant differences in the univariate analysis were included in the multiple ordinal logistic regression analy-sis model for both tuberculosis patients and healthy individuals.The results showed that the level of education, veg-etable intake, moderate food diversity score (DDS) of 4-6 were independent influencing factors of nutritional sta-tus BMI among tuberculosis patients (P<0.05);marital status was an independent influencing factor of nutritional status BMI among non-tuberculosis patients (P<0.05);while gender and occupation were independent influencing factors of nutritional status BMI among healthy individuals (P<0.05).Conclusion The dietary nutritional status of the three population groups varied.Targeted health education should be conducted, especially for tuberculosis patients, to address the issue of uneven dietary intake and promote good dietary habits among local tuberculosis pa-tients.

Objective:To explore the clinical features and prognosis of central nervous system involvement in patients with microscopic polyangiitis (MPA).Methods:We retrospectively investigated the clinical data of 138 MPA patients hospitalized with MPA in Tianjin Medical University General Hospital from January 1, 2010 to November 1, 2019. Patients were divided into two groups according to whether they had the central nervous system (CNS) involvement or not and then Kaplan-Meier survival curve was used to analyze the survival rate between the two groups, Logistic regression model analysis was adopted to analyze risk factors, and P<0.05 was considered statistically significant. Results:①29 patients (21.0%)among the 138 MPA had CNS-affected, including 13(44.8%) males and 16(55.2%) females. CNS involvement was present at the diagnosis of MPA in 20 cases (69.0%) and after the diagnosis of MPA in 9 cases (31.0%). ②The clinical manifestations were motor impairment in 14 cases (48.3%), sensory impairment in 10 cases (34.5%), speech loss in 9 cases (31.0%), headache in 8 cases (27.6%), consciousness disorder in 7 cases (24.1%), dysphagia and bucking in 4 cases (13.8%), cranial nerves involvement in 3 cases (10.3%). The imaging manifestations of the head included infarction, hemorrhage, infarction with hemorrhage and linear dural thickening. Five patients received lumbar puncture. One patient showed elevation of cerebrospinal fluid pressure, 1 patient had elevated protein and 5 patients showed elevation of LDH.③Eighteen patients received glucocortoid combined with cyclophosphamide. CNS symptoms recurred in 6 patients, four patients had recurrent cerebral infarction. ④Median survival time was 55 months in the CNS affected group [95% CI=(14.215, 95.785)] and 86 months in the N-CNS group [95% CI=(24.378, 147.622)]. Kaplan-Meier survival curve showed that there was no significant difference in survival rate between the two groups ( χ2=0.07, P=0.794) . Conclusion:The central nervous system involvement of microscopic polyangiitis is not uncommon. The clinical manifestations are various, with motor impairment the most. The most common imaging manifestation is cerebral infarction and the patients mainly presenteas multiple cerebral infarction. However, the CNS involvement of microscopic polyangiitis is not associated with mortality.