BACKGROUND:To maintain the long-term effect of ful crown largely depends on the health of periodontal tissues. OBJECTIVE:To explore the effect of CAD/CAM zirconia al-ceramic crown restoration on the state of periodontal health. METHODS:Sixty-four abutments of 55 patients were randomly divided into two groups:the experimental group included 32 abutments of 29 patients which would be restored by CAD/CAM zirconia al-ceramic crowns;the control ed group included 32 abutments of 26 patients which would be restored by Ni-Cr al oy porcelain-fused-to-metal restorations. The volume of gingival crevicular fluid and the levels of interleukin-6 and tumor necrosis factor-αin the two groups were examined at the pre-restoration and post-restoration stages. Meanwhile, periodontal clinical indicators, including sulcus bleeding index, probing depth, plaque index and attachment loss were recorded. RESULTS AND CONCLUSION:No difference in various indexes was found in the experimental group before and after restoration (P>0.05). At 12 months after restoration, in the control group, the volume of gingival crevicular fluid, the levels of interleukin-6 and tumor necrosis factor-α, sulcus bleeding index, probing depth, and plaque index were al increased (P>0.05);meanwhile, these indexes in the experimental group were significantly lower than those in the control group (P<0.05). Experimental findings suggest that the CAD/CAM zirconia al-ceramic crown restoration is more favorable to the health of periodontal tissues.

Objective To explore weaning dependent patients off mechanical ventilation through rehabilitative treatment. Methods Eighty-four patients dependent on mechanical ventilation were randomly divided into a rehabilitation group (n =44) and a control group (n =40). All were treated with routine medication, but in addition patients in the rehabilitation program followed a rehabilitation program. Three weeks later, the success rates and the time of weaning off mechanical ventilation were observed in the two groups. Results In the rehabilitation group,88.6% of the patients were successfully weaned off mechanical ventilation, versus 60% of the control group. The respective average weaning times were 6.8 ± 3.8 days and 14.3 ± 5.2 days. Both differences were statistically significant. Conclusions Rehabilitative treatment improves the weaning success rate and reduces the time needed for weaning mechanical ventilation-dependent patients.

Objective:To explore the expression of peptidyl prolyl cis-trans isomerase (Pin1) activity in peripheral blood of patients with rheumatoid arthritis (RA) and the value and correlation of T helper cell 17/regulatory cells (Th17/Treg) cells, and to analyze the effect and influence of all-transretinoic acid (ATRA) on it.Methods:① Comparing the difference of Pin1 expression and absolute counts of Th17 and Treg between RA patients before and after treatment and healthy control group, Kruskal-Wallis rank sum test was used for analysis. ② To analyze the correlation between the expression of Pin1 and its general data, activity indicators [such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and disease activity score 28 joints (DAS28) scores], Th17, Treg and some cytokines in RA patients, and to use Pearson and Spearman correlation tests. ③ To analyze the difference of Pin1 expression and Th17/Treg in peripheral blood of RA patients treated with low-dose all-trans retinoic acid (10 mg twice a week) and traditional immunosuppressants such as hydroxychloroquine for 3 months respectively. Mann-Whitney U test was used for comparison between the two groups, and the difference was statistically significant with ( P<0.05). Results:① The activity of Pin1 in peripheral blood of the newly treated group of RA was [13.62(9.16, 19.42)] higher than that of the healthy control group [8.97(7.62, 11.45)]( Z=42.82 , P<0.05), and Th17 was [18.28(12.76, 24.08)] higher than that of the healthy control group [6.04(4.96, 4.96)]( Z=48.83 , P<0.05). Treg [11.06(5.31, 21.87). It was lower than that of healthy control group [40.41(24.33, 48.52)]( Z=42.21 , P<0.05). ② the activity of Pin1 in peripheral blood of RA patients was positively correlated with CRP, the number of involved joints, DAS28 score, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) ( r=0.396, P<0.05; r=0.683, P<0.05; r=0.466, P<0.05; r=0.315, P<0.05; r=0.416, P<0.05). ③ Compared with the newly treated RA group, the activity of Pin1 [6.94(5.96, 8.77), Z=42.82 , P<0.05] and Th17 7.38 decreased [7.38(3.85, 11.21), Z=48.83 , P<0.05], while Treg [40.41 (17.77, 33.47)] increased ( Z=42.21 , P<0.05). ④ Compared with the traditional medicine group, Treg [28.9(21.73, 37.36)] was higher in the retinoic acid group, and the difference was statistically significant ( Z=-2.683 , P<0.05). The activity of Pin1 was [6.23(5.58, 8.75)], but there was no statistical significance ( Z=-1.622 , P=0.104). Conclusion:Pin1 in peripheral blood of RA patients is over-expressed. Th17 is increased and Treg is decreased. ATRA combined with other traditional drugs can reduce Pin1 activity, promote Treg growth and improve disease activity of RApatients to a certain extent.

Objective:To investigate the effects of dexmedetomidine on monocyte pyroptosis in peripheral blood of patients with cardiac valve replacement.Methods:Forty-four American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 45-64 yr, with body mass index of 18-25 kg/m 2, of New York Heart Association Ⅱ or Ⅲ, scheduled for elective cardiac valve replacement, were divided into 2 groups ( n=22 each) using a random number table method: dexmedetomidine group (group Dex) and normal saline group (group NS). In group Dex, dexmedetomidine was intravenously infused in a dose of 0.5 μg/kg over 10 min starting from the end of anesthesia induction, followed by a continuous infusion at 0.5 μg·kg -1·h -1 until the end of operation, while the equal volume of normal saline was given instead of dexmedetomidine in group NS.Before skin incision (T 1), at 30 min after the beginning of cardiopulmonary bypass (CPB) (T 2), immediately after the end of CPB (T 3) and at 24 h after CPB (T 4), the blood samples of internal jugular vein were collected for determination of the concentrations of plasma interleukin-18 (IL-18) and IL-1β (by enzyme-linked immunosorbent assay), and the expression of NOD-like receptor family, pyrin domain containing 3 (NLRP3), caspase-1 and gasdermin-D (GSDMD) in monocytes (by Western blot). The intraoperative consumption of propofol, sufentanil and norepinephrine, time of postoperative mechanical ventilation and time of intensive care unit stay were recorded. Results:The levels of plasma IL-18 and IL-1β and expression of NLRP3, caspase-1 and GSDMD in monocytes were significantly higher at T 2-4 than at T 1 in two groups ( P<0.05). Compared with group NS, the levels of plasma IL-18 and IL-1β were significantly decreased and the expression of NLRP3, caspase-1 and GSDMD was down-regulated at T 2-4, postoperative mechanical ventilation time was shortened ( P<0.05), and no significant change was found in the consumption of propofol, sufentanil and norepinephrine and time of intensive care unit stay in group Dex ( P>0.05). Conclusion:The mechanism by which dexmedetomidine reduces inflammatory responses may be related to inhibiting the NLRP3/caspase-1 pathway and reducing monocyte pyroptosis in the patients undergoing cardiac valve replacement.

Objective: To explore the relationship between sedentary behavior with cardiorespiratory fitness and executive function in adolescents, and to provide some references for sedentary behavior prevention and executive function improvement. Methods: From September to December 2022, a total of 5 018 adolescents aged 13 to 18 years were selected by stratified random sampling method in Shanghai, Suzhou, Taiyuan,Wuyuan, Xingyi, and Urumqi to conduct physical activity survey, as well as cardiorespiratory fitness and executive function assessment. Pearson s correlation was used to analyze the relationship between sedentary behavior, cardiorespiratory fitness and executive function. The mediation effect model was fitted by the bootstrap mediation procedure in the PROCESS (version 3.3 ) SPSS macro compiled by Haves, and the mediation effect of adolescents cardiorespiratory fitness in the relationship between static behavior and executive function was examined using model 4 in the PROCESS SPSS macro, where Boosrap method was used to compute the mediation effect of adolescents cardiorespiratory fitness. where the Boosrap method was used to calculate confidence intervals for the mediating effects. Results: Adolescents daily sedentary time was positively correlated with both the refreshing function (1-back and 2-back) and the switch function reaction time ( r =0.05, 0.07, 0.05, P <0.01). Adolescent VO 2max was negatively correlated with both the refreshing function (1-back,2-back) and the switching function ( r =-0.09, -0.14 , -0.11, P <0.01). Adolescents daily sedentary time was negatively correlated with VO 2max ( r =-0.04, P <0.01); cardiorespiratory fitness mediated effect values between sedentary behavior and refreshing function (1-back and 2-back) and converted function were 0.20(95% CI =0.06-0.36), 0.43(95% CI =0.14-0.74) and 0.13 (95% CI =0.04-0.22), with mediating effect shares of 6.87%, 8.33% and 8.59%, respectively. Conclusion The duration of sedentary behavior in adolescents is related to executive function performance, and cardiorespiratory fitness may serve as a mediator to mediate the association between sedentary behavior and executive function in adolescents.

Objective To explore the clinical effect of methylprednisolone on RMPP combined bacterial infection. Methods Sixty cases of children with ARMPP combined bacterial infection were selected and were divide into experi-mental group and the control group. The control group was given anti-infection treatment and support therapy,and the experimental group was given methylprednisolone early in addition. The duration of typical symptoms,the time of ima-geological change and the length of hospital stay were compared. Results The duration of typical symptoms of experi-mental group was significantly shorter than the control group,imaging findings improved significantly,and the average hospital day of experimental group was shorter than that of control group. Conclusion Methylprednisolone has remark-able curative effect on RMPP combined bacterial infection,it is worth to promote in the clinical practice.

Sleep apnea (SA) detection method based on traditional machine learning needs a lot of efforts in feature engineering and classifier design. We constructed a one-dimensional convolutional neural network (CNN) model, which consists in four convolution layers, four pooling layers, two full connection layers and one classification layer. The automatic feature extraction and classification were realized by the structure of the proposed CNN model. The model was verified by the whole night single-channel sleep electrocardiogram (ECG) signals of 70 subjects from the Apnea-ECG dataset. Our results showed that the accuracy of per-segment SA detection was ranged from 80.1% to 88.0%, using the input signals of single-channel ECG signal, RR interval (RRI) sequence, R peak sequence and RRI sequence + R peak sequence respectively. These results indicated that the proposed CNN model was effective and can automatically extract and classify features from the original single-channel ECG signal or its derived signal RRI and R peak sequence. When the input signals were RRI sequence + R peak sequence, the CNN model achieved the best performance. The accuracy, sensitivity and specificity of per-segment SA detection were 88.0%, 85.1% and 89.9%, respectively. And the accuracy of per-recording SA diagnosis was 100%. These findings indicated that the proposed method can effectively improve the accuracy and robustness of SA detection and outperform the methods reported in recent years. The proposed CNN model can be applied to portable screening diagnosis equipment for SA with remote server.
Electrocardiography ; Humans ; Machine Learning ; Neural Networks, Computer ; Sensitivity and Specificity ; Sleep Apnea Syndromes/diagnosis*

Objective:To evaluate the prognostic value of extravascular lung water index (EVLWI) , soluble intercellular adhesion molecule-1(sICAM-1) and Krebs yon den lungen-6 (KL-6) in severe pneumonia patients with Severe Acute Respiratory Syndrome (ARDS).Methods:A prospective study was conducted in Respiratory Intensive Care Unit of the Affiliated Zhengzhou Central Hospital of Zhengzhou University from October 2017 to February 2020. The study included 65 severe pneumonia patients with ARDS, who was performed by measurement of pulse index continuous cardiac output and survived more than 3days after admission. The Extravascular Lung Water Index (EVLWI) , sICAM-1, KL-6 and Oxygenation Index(OI) on 1st, 3rd and 5th day were detected. APACHEⅡ score, patient survival events (days) and survival outcome were recorded. Correlation analysis between EVLWI, sICAM-1, KL-6 and OI was performed on the 1st, 3rd and 5th day after admission. Independent risk factors of mortality in severe pneumonia patients with ARDS were analyzed by multiple logistic regression. Receiver operating characteristic curve was drawn, and the prognostic value of each parameter was assessed finally.Results:The PCT, EVLWI, sICAM-1, KL-6 and APACHEⅡ score in the death group were significantly higher than those in the survival group ( P<0.05) at RICU admission, and the length of RICU stay was significantly shorter than that in the survival group ( P<0.05), while differences in other clinical characteristics between two groups were not statistically significant ( P>0.05) . These parameters including levels of EVLWI, sICAM-1, KL-6, Procalcitonin and APACHE Ⅱscore in the death group were significantly higher than those in the survival group on the 1st, 3rd and 5th day ( P<0.05), whereas the OI was significantly lower than that of the survival group on the 3rd and 5th day ( P<0.05). Logistic regression analysis showed that EVLWI, sICAM-1, KL-6 level were significantly related with the mortality of these patients. The levels of sICAM-1, kl-6 and EVLWI on 1st, 3rd and 5th day after RICU admission showed a significant negative correlation with OI ( P<0.001). Whereas, The levels of sICAM-1, kL-6 on 1st, 3rd and 5th day showed a significant positive correlation with EVLWI ( P<0.001). The sensitivity and specificity of sICAM-1, KL-6 combined with EVLWI in prognosis evaluation on 1st, 3rd and 5th day were 75.0%, 84.4%, 85.0%, 66.7%, 80.0%, 86.7%, respectively. The AUC was 0.864, 0.881, 0.892 on 1st, 3rd and 5th day, respectively ( P<0.001), which had a better prognostic value than each of them. Conclusions:EVLWI, sICAM-1 and KL-6 were independent risk factors for the prognosis of severe pneumonia patients with ARDS. The combination of EVLWI, sICAM-1 and KL-6 might be important in early predicting the prognosis of the 28d mortality.

Objective:To investigate the stability and feasibility of improved silent MRA technique based on hybrid-arterial spin labeling(ASL) for imaging intracranial arterial stenosis.Methods:From September 2019 to May 2020, totally 35 patients with suspected intracranial vascular stenosis in Department of Neurology of Northern Jiangsu People′s Hospital were enrolled in this study. Silent MRA and improved silent MRA based on hybrid-ASL technique were performed respectively. The acquisition noise (noise measurement and subjective score) of two kinds of MRA examination were evaluated respectively. Two neuroradiologists performed image quality scoring and signal-to-noise ratio (SNR) measurement of intracranial arteries (including internal carotid artery, vertebrobasilar artery, anterior cerebral artery, middle cerebral artery, and posterior cerebral artery) in the two kinds of MRA images using a double-blind, completely randomized method. Independent sample t-test was used to compare the image quality and SNR of two kinds of MRA images in each segment. Two experts assessed the degree of stenosis at the site of confirmed intracranial artery stenosis. Kappa test was used to assess interobserver and intermodel agreement. Results:There was no significant difference in acquisition noise between improved silent MRA and silent MRA ( P>0.05). In all five segments measured, the image quality scores of internal carotid artery [(4.40±0.49)scores], anterior cerebral artery[(4.30±0.33)scores] and middle cerebral artery [(4.46±0.34)scores] in improved silent MRA were higher than those in silent MRA images [(4.02±0.43)scores, (4.02±0.31)scores, (4.02±0.31)scores; t=2.825, 2.877, 1.683, all P<0.05)]. The SNR of internal carotid artery (9.11±1.23) and middle cerebral artery (8.77±1.87) in improved silent MRA images was higher than that in silent MRA images (7.83±1.33, 8.06±2.67, respectively; t=11.154, 3.268, both P<0.05). A total of 24 patients (38 lesions) with intracranial vascular stenosis were diagnosed by CTA. Improved silent MRA (Kappa=0.89, 95%CI 0.82-0.95) and silent MRA (Kappa=0.85, 95%CI 0.77-0.92) were highly consistent among observers in evaluating the degree of cerebrovascular stenosis.The results of improved silent MRA were highly consistent with those of CTA (Kappa=0.92, 95%CI 0.87-0.98), and those of silent MRA were highly consistent with those of CTA (Kappa=0.85, 95%CI 0.77-0.92). Conclusions:The improved silent MRA is feasible to improve the imaging quality and signal uniformity through efficient marking based on keeping the low noise features. In the diagnosis of intracranial stenosis and occlusive disease, the stability of improved silent MRA imaging improves the diagnostic efficiency of stenosis to a certain extent.