Objective: To study the influences of electrolytic voltages on chromatics of anodized titanium. Methods:Titanium specimens were anodized in 0.5 mol/L sulfuric acid and 0.2 mol/L phosphate acid electrolyte using different voltages. The colors of anodized titanium were measured with a computer controlled spectrophotometer, and then evaluated in the CIE1976L*a*b* uniform color scale and Mussell notation. Result: One given volt created one distinguished color. The chromatic values expressed in L*a*b* were fluctuated in different voltage conditions. The hues in Mussell notation were distributed widely within R,Y,G,P of 5 basic colors and YR,GY,BG,PB of 5 interspace colors in the range of 5 to 80 volts. Anodizing with 10 or 45 volts, the specimen's colors appeared two kinds of brilliant goldish yellow, the former reddish slightly and latter greenish a little. The spectrums of the two colors were in the range of wavelengths of yellow to red. Conclusion: The color of the anodized titanium is dependent upon the volts applied. The goldish yellow may be used to improve the esthetics of titanium dentures.

Objective To verify the validity and feasibility of national early warning score (NEWS) in evaluation of death risk in elderly patients with critical illness,in order to find out which scoring method is more suitable for elderly critical illness patients.Methods A prospective case-control study was conducted.The critical illness patients aged over 60 years old with the length of hospital stay over 24 hours,and admitted to Department of Emergency of Qingdao Municipal Hospital from January to December 2015 were enrolled.The clinical data including in emergency and the actual outcome of patients were collected,and the patients were divided into death group and survival group according to 30-day outcome.Patients in the two groups were assessed by using NEWS and risk classification according to the first results of vital signs monitoring.Multivariate logistic regression model was used to analyze the relationship between the NEWS classification and the risk of death in elderly critical ill patients.Results 1 950 emergency elderly patients with critical illness were enrolled,with 78 cases (4.0％) dead within 30 days and 1 872 survived (96.0％).Compared with the survival group,patients in death group were older (years:79.8 ± 10.8 vs.75.3 ± 8.9,t =4.335,P ＜0.001),and had higher acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score (22.9± 4.6 vs.18.2 ± 4.8,t =8.487,P ＜ 0.001),lower Glasgow coma scale (GCS) score (12.2 ± 4.5 vs.13.4 ± 5.2,t =-2.007,P =0.045),higher incidence of respiratory system diseases (29.5％ vs.17.9％,x 2 =12.742,P =0.013),higher NEWS score (11.2 ± 5.5 vs.3.9 ± 2.7,t =22.063,P ＜ 0.001),as well as higher proportion of patients with NEWS classification of high risk and very high risk (65.4％ vs.15.8％,x 2 =263.125,P ＜ 0.001).With the increase of NEWS risk classification,mortality rate was also increased,and the mortality rate in the patients with low,medium,high and very high risk were 0.81％ (9/1 108),3.63％ (18/496),5.83％ (13/223),30.89％ (38/123),respectively,with statistically significant difference (x 2 =179.741,P ＜ 0.001).It was showed by logistic regression analysis that the NEWS score of elderly patients with critical illness were positively correlated with 30-day death.The 30-day death risk of patients with middle risk,high risk and very high risk was 4.600,9.052 and 54.598 folds of the patients with low risk respectively.Conclusion NEWS score can be used to assess the risk of death in emergency elderly patients with critical illness.NEWS risk classification can quantify and classify the risk of death in the elderly patients with critical illness.

Objective To evaluate the efficacy of modified quadruple therapy for patients who were failed in previous Helicobacter pylori ( Hp) eradication treatment .Methods A total of 86 patients with confirmed Hp infection and failed in previous Hp eradication treatment were collected from Qingdao Municipal Hospital during January 2012 and January 2014.Patients were randomly assigned into two group:43 patients in control group were given conventional quadruple therapy ( rabeprazole +colloidal bismuth pectin +amoxicillin +clarithromycin for 14 d ) , and 43 patients in test group were given modified quadruple therapy ( rabeprazole +colloidal bismuth pectin +amoxicillin +clarithromycin for 7 d, and lansoprazole +colloidal bismuth pectin +levofloxacin +metronidazole for 7 d).Chi square test was performed to analyze per-protocol (PP) eradication rates, intent-to-treat (ITT) eradication rates, and Hp recurrence rates between two groups .Results Among 43 patients in test group , 42 completed treatments with PP eradication rate of 100.00% and ITT eradication rate of 97.67%.All patients in control group completed treatments , and Hp eradication was observed in 24 patients , and both PP and ITT eradication rates were 55.81%.The differences in PP and ITT eradication rates between two groups were of statistical significance (χ2 =23.90 and 21.11, P<0.05).The 3-month and 6-month Hp recurrence rates in test group (14.29%and 20.00%) tended to be lower than those in control group (20.83%and 34.78%), but the differences were not of statistical significance (χ2 =0.12 and 1.68, P>0.05).Conclusion The efficacy of modified quadruple therapy for patients who were failed in the previous Hp eradication treatment is satisfactory.

Objective:To evaluate the value of the crescent sign for predicting the invasiveness of lung adenocarcinoma presenting as pure ground-glass nodule (pGGN).Methods:The clinical, pathological and imaging data of 316 patients (320 pGGNs) confirmed lung adenocarcinoma by surgery and pathology from July 2013 to June 2018 in the First Affiliated Hospital of Wenzhou Medical University were retrospectively analyzed. All pGGNs were divided into preinvasive group (148 pGGNs) and invasive group (172 pGGNs) according to histopathology. Logistic regression analysis was used to determine the risk factors for invasiveness of pGGN, and the ROC curve analysis was performed on each risk factor.Results:Crescent sign was found in 24 cases (16.2%) in the preinvasive group and 49 (28.5%) in the invasive group, and the difference between the two groups was statistically significant (χ2=6.804 ,P=0.009).There were statistically significant differences in patient′s age, lesion size, shape, lobulation sign, and vascular stretch sign between the two groups ( P<0.05). The ROC curve showed that with the lesion size 10.5 mm as the optimal cut off value, the sensitivity for differential diagnosis of preinvasive and invasive lesions was 65.7%, the specificity was 61.5%, and the area under the curve was 0.666. Logistic regression analysis showed that maximum diameter of the lesion ≥10.5 mm, irregular shape, crescent sign and vascular stretch were independent risk factors of invasiveness of pGGN, and the OR value (95%CI) were 3.192 (1.981-5.144), 3.672 (1.545-8.725), 1.972 (1.104-3.521), and 2.026 (1.087-3.777), respectively. A logistic model was established based on the above four independent risk factors, and the area under curve was 0.711 (95%CI 0.655-0.768). Conclusion:Crescent sign can effectively reflect the invasiveness of pGGN. Maximum diameter of the lesion ≥10.5 mm, irregular shape, crescent sign and vascular stretch sign are independent risk factors of invasiveness of pGGN.

Objective To evallhte factors affecting blood loss during mini-percutaneous nephrolithotomy using ureteroscope and pneumatic intracorporeal lithotripsy(MPCNL). Methods 1156MPCNL procedures in 885 patients from July 2002 to October 2006 were reviewed. Various patientrelated and intraoperative factors were assessed for association with total blood loss using multivariate regression analysis. ResuIts The average hemoglobin drop was(14.2+8.3)g/L.The overall blood transfusion rate was 1.5%. Approximately 0.6%of patients required angiography embolization to control intractable bleeding. Multivariate regression analysis showed that the occurrence ot operative complications(6=0.496,P＜0.001),size of the tract(b=0.405,P＜0.001),mature nephrostomy tract(6=0.377,P＜0.001),multiple tracts(6=0.326,P=0.005),size of stone(b=0.210,P=0.015),operative time(6=0.139,P=0.027),renal parenehymal thickness(b=0.128,P=0.035),prior stone intervention(b=-0.121,P=0.038),diabetes(b=0.110,P=0.051),and bacteriuria(b=-0.095,P=0.058)were significant predictors of blood loss.Factors such as age,sex,side,obesity,hypertension,renal function,operating surgeon,anaesthesia,calix of puncture,number of attempts to successful puncture,urine from puncture needle may not affect the blood loss. Concluslons Maneuvers that may reduce blood loss include reducing the operative time,decreasing the occurrence of intraoperative complications, reducing the tract size and tract number, and staging the procedure.Staging the procedure of MPCNL is a judicious decision in case of a large stone burden,intraoperative complications,multiple-tract,lager tract or diabetes.

Objective To analyze survival benefits of radiotherapy in patients with nasopharyngeal carcinoma (NPC) with distant metastases and analyze relevant prognostic factors.Methods Medical records of 329 patients newly diagnosed with metastatic NPC screened from the Surveillance,Epidemiology and End Results (SEER) database (199 of 329 patients received radiotherapy) between 2010 and 2015 were retrospectively analyzed.Overall survival (OS) and disease-specific survival (DSS) were calculated by Kaplan-Meier curve.The effect of different clinicopathological factors on the clinical prognosis of metastatic NPC patients was evaluated by logrank test and Cox regression analysis.Results The median follow-up time was 12 months.The 3-and 5-year OS rates were 27.4％ and 19.7％.The median OS was 17.9 months.Univariate analysis demonstrated that patients aged＜ 50 years,male,undifferentiated type,stage T3 or T4,positive regional lymph node,brain and liver metastases and 1-2 metastatic sites obtained OS and DSS benefits at 3 years after radiotherapy.Univariate and multivariate Cox analyses after propensity score matching showed that radiotherapy was an independent prognostic factor for metastatic NPC (OS,P=0.004;DSS,P=0.014).Besides,patients aged 60-69 years (OS,P=0.033;DSS,P=0.045),keratinizing squamous cell carcinoma (OS,P＜ 0.05;DSS,P＜ 0.05),stage T4 (OS,P =0.002;DSS,P =0.024),1-2 metastatic sites (OS,P =0.039;DSS,P =0.058),3-4 metastatic sites (OS,P =0.003;DSS,P =0.005) and no chemotherapy (OS,P=0.000;DSS,P=0.000) had poor OS and DSS,whereas sex,race and degree of differentiation exerted no effect on OS and DSS.Conclusions Radiotherapy can significantly improve the OS and DSS of patients with metastatic NPC.Prospective and randomized controlled studies are required to further explore the role of radiotherapy in the management of metastatic NPC.

ATP-binding cassette (ABC) transporters are the largest transporter families in human bodies; they are widely distributed and have complex functions. ABC transporters can mediate the translocation of various substrates on the cell membrane. This paper summarizes the structure, classification, function and action mechanism of ABC transporters and the research progress of ABC transporters in AD in recent years, and discusses the future research direction for preventing and treating AD in this field to provide new ideas and references for the prevention and treatment of AD.

Objective To observe the effect of rat bone marrow mesenchymal stem cells(BMSCs)on the apoptosis of rat peritoneal mesothelium cells(PMCs)induced by high glucose peritoneal dialysis fluid(PDF),and to explore its possible molecular mechanism.Methods The primary BMSCs and PMCs were extracted and identified.Apoptosis of PMCs was induced by high glucose PDF.Cell supernatant from BMSCs after 24 h of culture was collected as the conditioned medium(BMSCs-CM).PMCs were co-cultured with BMSCs by conditioned media or Transwell chambers.PMCs were randomly divided into the control group,the PDF group and the PDF+BMSCs-CM group.The viability of PMCs was measured by CCK-8 in each group.The depolarization of mitochondrial membrane potential was measured by JC-1 method.TUNEL staining was used to detect cell apoptosis.Western blot assay was used to detect the expression levels of apoptosis related proteins B-cell lymphoma-2(Bcl-2),Bcl-2 associated X protein(Bax),Cleaved cysteine aspartase-3(Cleaved Caspase-3)and pathway related protein serine/threonine protein kinase(Raf),mitogen-activated extracellular signal-regulated kinase(MEK),extracellular-signal regulated protein kinase(ERK)and their phosphorylated proteins in each group.Results Compared with the control group,the proliferative activity and mitochondrial membrane potential of PMCs were decreased in the PDF group,while the apoptosis rate and the ratio of Bax/Bcl-2,Cleaved Caspase-3/Caspase-3,p-Raf/Raf,p-MEK/MEK and p-ERK/ERK were increased(P＜0.05).Compared with the PDF group,the proliferative activity and mitochondrial membrane potential of PMCs were increased in the PDF+BMSCs-CM group,while the apoptosis rate and the ratio of Bax/Bcl-2,Cleaved Caspase-3/Caspase-3,p-Raf/Raf,p-MEK/MEK and p-ERK/ERK were decreased(P＜0.05).Conclusion BMSCs can reduce the apoptosis of PMCs induced by high glucose PDF,and its mechanism maybe related to inhibiting the activation of Raf/MEK/ERK signaling pathway.