Objective To compare the accuracy of cone-beam computed tomography (CBCT ) and periapical radiography in the diagnosis of simulated external apical root resorption (EARR) .Methods The study sample comprised 160 single-rooted premolars for simulating 4 degrees of EARR :no(intact teeth) ,mild(cavity of 1 .0 mm in diameter and depth in root surface) ,moderate(1 .0 mm root shortening) ,and severe(3 .0 mm root shortening) .Two sets of radiographic images were acquired with CBCT and periapi-cal radiography .The severity for all resorption lesions were evaluated blindly by one calibrated examiner .The percentages of correct classification of each degree of EARR were compared between the two imaging techniques using McNemar test .Results With CBCT method ,the percentages of correct classification of no ,mild ,moderate ,severe and all EARR were 95 .0% ,97 .5% ,42 .5% , 87 .5% and 80 .6% ,respectively ;with periapical radiography method ,the percentages were 85 .0% ,42 .5% ,70 .0% ,92 .5% and 72 .5% ,respectively .Significant differences were found between the two imaging techniques for evaluating mild ,moderate ,and all-EARR(P<0 .05) .Conclusion CBCT imaging is more reliable than periapical radiography for detecting EARR ,whereas it is not sensitive to moderate root shortening .In orthodontic practices ,CBCT could be applied to the early diagnosis of EARR ,in order to help make the decision on continuation and modification of orthodontic treatment .

Objective To prepare a novel ultrasound contrast agent , targeted phase-shift lipid nanoparticles mediated by tumor homing and penetrating peptide tLyP-1 ,and to evaluate its characteristics . Methods The nanoparticles were prepared by filming-rehydration and acoustic-vibration methods .The morphology ,distribution ,particle size and zeta potential were detected . After heating and irradiating of low intensity focused ultrasound ( LIFU) ,the phase-shift characteristic and the enhancement effect in vitro were observed . The tumor homing and cell-penetrating properties of the nanoparticles were examined by confocal laser scanning microscopy and flow cytometry . The cytotoxicity of the nanoparticles was evaluated by CCK 8 assay . Results The size and distribution of nanoparticles were uniformed . The size and zeta potential of nanoparticles were ( 399 .50 ± 29 .98) nm and ( 3 .28 ± 1 .72) mV ,respectively . When the nanoparticles were heated to a temperature of 45 ℃ or after irradiated by LIFU ,nanoparticles generated phase-shift and enhanced ultrasound imaging in vitro ( P < 0 .05 ) . The confocal laser scanning microscopy showed that nanoparticles mediated by tLyP-1 can targetedly aggregate to cell membrane of MDA-MB-231 and penetrate into the cell ,but not to HUVEC . The flow cytometry showed that intracellular fluorescence intensity of nanoparticles mediated by tLyP-1 in MDA-MB-231 group was higher than that in control groups ( P <0 .05) . The CCK8 assay indicated that different concentrations of nanoparticles had no significant effects on cell activity ( P > 0 .05 ) . Conclusions A novel ultrasound contrast agent , targeted phase-shift lipid nanoparticles mediated by tumor homing and penetrating peptide tLyP-1 ,is prepared successfully . It can target to MDA-MB-231 cell and penetrate into the cell in vitro ,and enhance ultrasound imaging in vitro after LIFU irradiation ,which expected to become a novel tumor targeted ultrasound contrast agent and achieve ultrasound molecular imaging at the level of tumor cell .

Objective To investigate the nursing intervention focused on solving model on improving the anxiety and depression of perioperative breast cancer patients .Methods A total of 120 perioperative breast cancer patients randomly divided into control group ( n=60 ) and observation group ( n=60 ) .Control group received routine care , while observation group received the intervention based on focusing solving model . Anxiety Rating Scale ( SAS ) and Self -rating Depression Scale ( SDS ) were used to assess the results . Results Before the intervention , the differences of SAS and SDS scores between observation group and control group were not statistically significant (P >0.05).After nursing intervention, SAS and SDS scores in observation group were (41.64 ±6.32), (42.61 ±6.40) points, respectively, lower than that in control group (57.07 ±7.32), (59.42 ±7.49) points, and the differences were statistically significant (t=11.29,10.28, respectively;P <0.01 ).Conclusions Focus solving model nursing intervention can significantly improve perioperative anxiety , depression and other negative emotions of breast cancer patients , help patients with treatment, increase surgical tolerance , improve surgical treatment , promote the body recovery .

Objective: To explore the relationship between childhood abuse, adult attachment and borderline personality disorder (BPD) in college students, and to provide reference for promoting the physical and mental health of college students. Methods: We selected undergraduate students from four colleges in Hefei, a total of 4 034 college students were surveyed by the childhood trauma questionnaire short form(CTQ-SF), the state adult attachment measure (SAAM) and the Personality Diagnostic Questionnaire(PDQ). Results: BPD was found in 4.2% of subjects, 4.5% of males and 3.7% of females. The score of BPD in non-single-parent families was lower than that in single-parent families, in families with average family economic status was lower than that in families with poor and good family economic status, and in families with medium father education level was lower than that in fathers with low and high education level(Z=-2.30, 29.25, 9.63, P<0.05). Childhood abuse, avoidant attachment and anxious attachment positively predicted BPD(β=0.21, 0.10, 0.23, P<0.01), secure attachment negatively predicted BPD(β=-0.15, P<0.01). Adult attachment played a partial mediating role in the effects of childhood abuse on BPD, with the mediating effect accounting for 16.7% of the total effect. Conclusion Adult attachment plays a mediating role in the effects of childhood abuse on BPD.

Objective To prepare an ultra-porous hydrogel capable of controlled release and investigate the drug loading, releasing, administration route and efficacy with insulin as a model drug. Methods The polymer interpenetrating network method was used to prepare ultra-porous hydrogels (SPH-IPN). Insulin was selected as a model drug to study the drug loading and efficacy. Fourier transform infrared spectroscopy and nuclear magnetic resonance carbon spectroscopy were used to investigate the structure of the gel. The swelling ratio and porosity were measured to evaluate the gel performance. Results The drug loading capacity of insulin ultra-porous hydrogel was 3.19%. The insulin-loaded freeze-dried gel exhibited good hypoglycemic effect on diabetic rats in 1−24 hours from the experimental results on rats with subcutaneous implantation. Conclusion The subcutaneously embedded lyophilized insulin ultra-porous hydrogel provided good controlled release efficacy. It maintained stable blood glucose levels within 24 hours.

Objective: To investigate the prevalence of witnessing domestic violence,and to explore the relationship between witness domestic violence in childhood and college students’ injury and violence behaviors. Methods: In October 2018, self-made questionnaire on “Health and Risky Behaviors among University Students in Anhui Province” was conducted among 4 034 college students from 4 universities in Hefei. Multivariate Logistic regression models (control of confounding factors) were used to explore the impact of childhood witnessing domestic violence on college students’ injury and violence. Results: Among 4 034 college students,the prevalence of witnessing domestic emotional violence,mild physical violence and severe physical violence in childhood was 27.6%,22.4%,10.7%,respectively. Univariate analysis showed that students with experiences of witness domestic emotional violence,mild physical violence and severe physical violence had higher rates of self-injury,physical,emotional,and sexual violence compared to those without domestic violence witness(P<0.05). Multivariate Logistic regression analysis showed that witnessing domestic severe physical violence,emotional violence in childhood associated positively with self-harm (OR=1.53,95%CI=1.05-2.23; OR=2.15,95%CI=1.51-3.04) and emotional violence (OR=1.65,95%CI=1.16-2.35; OR=2.57,95%CI=1.87-3.53). Witnessing domestic severe physical violence showed positive association with physical violence (OR=4.99,95%CI=2.58-9.62) and sexual violence (OR=8.68,95%CI=3.30-22.81) among college students (P<0.05). Conclusion The experiences of witness domestic violence can increases the risk of college student’s injury and violence behaviors,especially witness domestic severe physical violence.

Objective To discuss the sleep quality of hospitalized patients with rheumatic diseases and the factors affecting the quality of sleep. Methods With Pittsburgh sleep quality index ( PSQI) questionnaire and the self-designed questionnaire about the factors affecting sleep were used to survey 125 patients with rheumatic disease from November 2013 to October 2014 in a level three class A hospital in Beijing city. Results Rheumatoid disease inpatients PSQI scores between 7 to 12 points had 35 cases, accounted for 28. 0%, more than 12 points having 6 cases, accounted for 4. 8%, PSQI various dimensions of 93 patients with seven hours of sleep time and accounted for 74. 4%, sleep efficiency more than 85% having 115 patients and accounted for 92. 0%, but the poor quality of sleep group with 113 cases and accounted for 90. 4%, sleep time group 101 cases of patients and accounted for 80. 8%, patients with sleep disorders in 120 cases, accounted for 96%, 111 cases of patients with daytime dysfunction, accounted for 88. 8%, and used hypnotic drugs in patients with only 13 cases, accounted for 10. 4%, group of patients with rheumatic disease of the Pittsburgh sleep quality index was higher than normal group (P<0. 01); there was no significant difference in the total score of PSQI and in patients with glucocorticoid (P <0. 05). The percentage of poor sleep quality was in patients with more than sixty years old, not continue to work or study and poor sleep before hospitalization, and sleep quality of patients affected by physical discomfort (P<0. 01);the primary factors affected patients′sleep was psychological factors. Conclusions The hospitalized patients with rheumatoid disease sleep quality are poor, while psychological factors are the main factors affecting sleep and corticosteroids is not absolutely the influencing factors of sleep. The elderly, the length of sleep before good quality patients should attract the attention of nurses. Using your own sleep drugs can improve sleep quality. Evaluation and assessment of patients′sleep quality can find out potential problems.

Objective To investigate the serum levels of dickkopf-related protein 1 (DKK1) and sclerostin (SOST) in patients with axial spondyloarthritis treated with selective cyclo-oxygenase 2 inhibitor and its relation to clinical efficacy.Methods A randomized double-blind controlled trial with axial spondyloarthritis (ax-SpA) was carried out in our hospital.The data from patients in a single center was collected and analyzed.Serum DKK1 and SOST levels were measured by enzyme-linked immuno sorbent assay (ELISA)method before and after 12 weeks treatment,then correlation analysis were conducted for DKK1 and SOST levels with erythrocyte sedimentation rate (ESR),C reactive protein (CRP),Bath ankylosing spondylitis disease activity index (BASDAI),Bath ankylosing spondylitis functional index (BASFI) and SPARCC of the sacroiliac joint inflammation score.Chi-square tests were used for analyzing of categorical data.Fisher exact tests were performed when the expected frequencies were less than 5.Two independent samples t-test was used to compare the difference between groups.Single sample t-test was used to ompare the differences between data before and after treatment.Pearson or Spearman correlation was used for correlation analysis.Results After 12 weeks of treatment,a total of 116 patients completed the follow-up,including 57 cases of imrecoxib group and 59 cases of the celecoxib group.There were no statistically significant difference between the two groups (P＞0.05).The level of serum DKK1 was significantly increased after treatment [(393±137) pg/ml,vs (542±274)pg/ml,P＜0.05].The serum level of SOST increased significantly [(39±19) pg/ml vs (57±36) pg/ml,t=5.814,P＞0.05],too.The difference between the two groups was not statistically significant (P＞0.05).Spearman correlation analysis showed that serum DKK1 was positively correlated with serum SOST (r=0.226,P=0.015).A significantcorrelation was found between SOST level and ESR,CRP,finger to floor distance,left and fight lumbar side flexion and Schober's test (ESR:r=-0.379,P＜0.01;r=-0.309,P=0.001;r=-0.225,P=0.015;r=0.185,P=0.047;r=0.247,P=0.008;r=0.214,P=0.021).Conclusion Imrecoxib and celecoxib have similar efficacy on relieving the signs and symptoms of patients with ax-SpA.Short-term application of selective COX-2 inhibitors can increase DKK1 and SOST and possibly delay radiographic progression.

The clinical application of immune checkpoint inhibitors (ICIs) has significantly improved the prognosis of hepatocellular carcinoma (HCC) patients. With the widespread applica-tion of ICIs in HCC, the management of immune-related adverse events (irAE) gained more and more attention. However, the complicated disease characteristics and various combination therapies in HCC throw out challenges to irAE management. Therefore, the editorial board of the 'Chinese expert consensus on the management of immune-related adverse events of hepatocellular carcinoma treated with immune checkpoint inhibitors (2021 edition)' organizes multidisciplinary experts to discuss and formulate this consensus. The consensus focuses on issues related to HCC irAE manage-ment, and puts forward suggestions, in order to improve standardized and safety clinical medication, so as to maximize the benefits of immunotherapy for patients.

OBJECTIVE：To summarize and analyze t he clinical characteristics of acarbose-induced skin ADR ，and to provide reference for its therapy. METHODS ：Clinical pharmacists participated in the treatment of a patient with acarbose-induced skin ADR. The patient developed erythema multiforme several days after oral administration of Acarbose tablets （100 mg/d）. After consultation by dermatology and clinical pharmacy ，considering that the adverse reaction was related to acarbose ，clinical pharmacists suggested to stop the drug. Based on the above cases ，clinical pharmacists searched Wanfang database ，CNKI， PubMed，Embase and other databases to collect case reports of skin ADR caused by acarbose ，summarize its general situation （gender，age，usage and dosage ，etc.），latency，ADR（diagnosis and manifestation ），intervention and outcome ，etc. RESULTS ： The doctor adopted the pharmacist s’advice，stopped the use of acarbose ，and gave symptomatic treatment as Methylprednisolone sodium succinate for injection 40 mg（intravenous injection ，qd）+Medloratadine tablets 8.8 mg（oral administration ，qd）+Calamine lotion（for external use ）. The patient improved and was discharged after 10 days. A total of 12 literatures involving 12 patients were retrieved. Among the 13 patients included in the analysis （including the above clinical case and 12 literature cases ），there were 8 males and 5 females，and 8 patients of them aged 50 and over；the dosage of acarb ose in most patients was within the requirements of the drug instructions. The primary diseases of 12 patients were diabetes mellitus. The latency of skin ADR in 11 patients was within 6 days of administration. Among the 13 patients，the ADR were diagnosed as rash in 4 cases，pustulosis in 3 cases， erythema multiforme in 2 cases， urticaria in 2 cases， maculopapular rash in 1 case and lip swelling in 1 case. The ADR of 1 patient improved after drug withdrawal ，and 12 patients also improved after drug withdrawal and symptomatic treatment such as glucocorticoid or antihistamine. Acarbose was re-used in 2 patients after the improvement of first skin ADR ，and skin ADR occurred again ，and the ADR were improved after drug withdrawal and symptomatic treatment. CONCLUSIONS ：Skin ADR are acarbose-induced rare ADR ，mostly within 6 days of medication ，and are more likely to occur in middle-aged and older men. When the patients suffer from ADR ，the drug should be stopped in time and given glucocorticoids or antihistamines for symptomatic treatment. Clinical pharmacists should do a good job in drug publicity and education ，remind patients to closely monitor relevant indicators and ensure drug safety.