OBJECTIVEThis study investigated the effects of hydroxyapatite (HA)/chitosan (CS)-transforming growth factor-β1 (TGF-β1) composite coatings on titanium surfaces, as well as on the attachment and proliferation of osteoblasts.

METHODSHA/CS-TGF-β1 composite coatings were prepared on titanium surfaces by physical, chemical, and biological modifications. Scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform-infrared spectroscopy (FTIR), and other methods were employed to analyze the chemical composition and surface topography of the composite coatings. CCK-8 and immunofluorescence assays were used to analyze the effects of the coatings on the attachment and proliferation of osteoblasts.

RESULTSHA/CS-TGF-β1 composite coatings were successfully prepared. Their contact angle was almost zero. These composite coatings were applied in vitro, with a drug released early and a burst release effect. The growth of osteoblasts was not inhibited on it and it had obvious promoting effect on the adhesion and early proliferation of osteoblasts.

CONCLUSIONThe composite coatings significantly promote the adhesion and early proliferation of osteoblasts in vitro. This finding shows that the proposed method demonstrates a good prospective application in surface modification of titanium.

Cell Proliferation ; Chitosan ; chemistry ; Dental Bonding ; methods ; Durapatite ; chemistry ; Microscopy, Electron, Scanning ; Osteoblasts ; physiology ; Prospective Studies ; Spectroscopy, Fourier Transform Infrared ; Surface Properties ; Titanium ; chemistry ; Transforming Growth Factor beta ; chemistry ; Transforming Growth Factors ; X-Ray Diffraction

Objective To investigate the effect of catch-up growth on insulin resistance(IR) through analysis of biochemical and metabolic indices in premature infants.Methods There were 126 infants admitted in the Department of Neonatology,the Affiliated Hospital of Guiyang Medical College from December 2010 to December 2013 [factors which might affect the secretion of insulin(INS),C peptide and insulin-like growth factor-1 (IGF-1) were excluded].According to gestational age and birth weight,babies were divided into small for gestational age (SGA) group and appropriate for gestational age (AGA) group.And according to the age on follow-up,babies were divided into 1-to-6-month-old group,7-to-12-month-old group and ≥ 1-to-3 year-old group.All cases had 6 mL peripheral venous blood sampled in the early morning during fasting in the first week,and 6,12,24,36 months after birth.They were tested for levels of INS,C peptide,IGF-1,triglyceride (TC),total cholesterol (TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),fasting blood-glucose (FBG),albumin,prealbumin and creatinine respectively.At the same time,the physical parameters were measured,including weight,body length,and calculated insulin resistance index (IRI),Ponderal index,weight standard deviation score (SDS),and length SDS.Results (1) Catch-up growth after premature birth occupied 65.6％ (63/96 cases),whereas no catch-up growth occupied 34.4％ (33/96 cases) of study snbjects,and among them catch-up growth of 37 cases was better (8 cases of SGA,29 cases of AGA),26 cases showing catch-up growth(7 cases of SGA,19 cases of AGA),33 cases without catch-up growth(11 cases of SGA,22 cases of AGA).No statistical significance was found in the distribution of catch-up growth between SGA group and AGA group(P ＞ 0.05).(2) The LgIRI,LgINS of group with good catch-up growth was significantly lower than the group with no catch-up growth group (F =3.55,3.47) in infancy,but the level of IGF-1 and prealbumin was higher than that of no catch-up growth group (F =3.55,4.94),the difference had statistical significance (P ＜ 0.05) ; the better catch-up growth was associated with higher IGF-1 and prealbumin,but with lower LgIRI.(3) The risk factors for insulin resistance were SGA (OR =7.904,P =0.001),low birth weight ＜ 1 500 g (OR=8.737,P=0.019),and no catch-up growth (OR=11.706,P=0.000).Conclusions The better catch-up growth in infancy is associated with higher IGF-1 and prealbumin,but lower IR.The risk factors of IR include SGA,low birth weight and no catch-up growth,and the last being the major factor.

Objective To analyze the value of cerebral coronary view of nose tip deflection in screening fetal facial deformity in the first and second trimester. Methods All cases were divided into the 11～12+6 weeks, the 13 ～ 14+6 weeks and the 15 ～ 16+6 weeks undergone ultrasonographic examination on coronal view of nose tip deflection. The display of fetal facial structure and the detection rate of fetal facial malformation were analyzed. Results The fetal facial anatomic structures were clearly displayed. The median sagittal section ,eyes level coronal section ,retronasal triangle section ,or other sections were satisfactory in 4855 cases (97.10％). There was no Statistical difference in the display of fetal facial structures among the three groups. 69 fetus were found with facial malformations,including 31 fetus with facial malformations only,and 38 fetus combined with other abnormal struc-tures. The sensitivity,specificity,positive predictive value and negative predictive value were 93.24％,100％, 100％ and 99.90％ respectively. Conclusion The cerebral coronary view of nose tip deflection method has high detection rate and sensitivity,and is a reliable method for detecting fetal facial abnormalities in the first and second trimester.

Objective:To understand the current situation and trend of nursing cost research in China so as to provide a reference for researchers in the field of nursing cost research.Methods:We retrieved literature on nursing cost from January 1, 1990 to December 13, 2019 in China National Knowledge Infrastructure (CNKI) . CiteSpace software was used for visual analysis.Results:A total of 463 related literature were obtained, and the number of publications was on the rise as a whole, and research institutions had little cooperation. Nursing economics, nursing human resources, nursing management, cost analysis were the main research directions at present. Long-term care insurance with the highest emergent word intensity was the research frontier in the field.Conclusions:We should strengthen the cooperation in scientific research institutions, and rely on big data, computers and other means to establish a nursing cost accounting model, and extend the scope of research to communities and homes so as to provide a quantitative basis for Chinese long-term care insurance compensation standards.

Objective:To retrieve, extract, evaluate and integrate relevant evidence on the prevention and management of exposure corneal injury in critically ill patients, so as to provide a reference for clinical practice.Methods:Based on the "6S" pyramid model of evidence resources, the database and relevant society websites were systematically searched from top to bottom for evidence on the prevention and management of exposure corneal injury in critically ill patients, including guidelines, expert consensus, evidence summaries, and systematic reviews. The retrieval time limit was from the establishment of the database to October 31, 2021. Two researchers independently assessed the quality of the article, extracted evidence from the article that met the quality standards, and adopted the Joanna Briggs Institute (JBI) evidence pre-grading and evidence recommendation system (2014 edition) to grade the evidence.Results:A total of 15 articles were included, including 2 guidelines, 2 evidence summaries, 6 systematic reviews, and 5 randomized controlled trials. A total of 42 pieces of the best evidence on the prevention and management of exposure corneal injury in critically ill patients were summarized, including five aspects, namely, assessment, daily management, risk management, drug management and procedure management.Conclusions:This study summarizes the best evidence for the prevention and management of exposure corneal injury in critically ill patients. When medical and nursing staff carry out clinical transformation, they should fully consider the actual situation of patients and select evidence in a targeted manner to reduce the incidence of ocular complications in critically ill patients.

Objective To evaluate the role of group Ⅱ metabotropic glutamate receptors (mGluRs) in cognitive decline caused by multiple administrations of ketamine in mice and the relationship with hippocampal glycogen synthase kinase-3 beta (GSK-3β) expression.Methods Forty-five SPF healthy female C57BL/6 mice,aged 6-8 weeks,weighing 20-30 g,were randomized into 3 groups (n=15 each) using a random number table method:control group (group C),ketamine group (group K) and mGluR agonist LY354740 group (group L+K).In K and L+K groups,ketamine 30 mg/kg was intraperitoneally injected three times a day at an 30-min interval for 14 consecutive days.LY354740 was intraperitoneally injected at 30 min before the first injection of ketamine in group L+K.The equal volume of normal saline was given instead in group C.Morris water maze test was performed the day after the last administration.The mice were then sacrificed,and hippocampi were harvested to determine the expression of GSK3β,NR2A and postsynaptic density protein 95 (PSD95) by Western blot.Results Compared with group C,the escape latency was significantly prolonged,the time of staying at the original platform quadrant was shortened,the frequency of crossing the original platform was decreased,the expression of GSK3β3 and NR2A was up-regulated,and the expression of PSD95 was down-regulated in group K (P＜0.05),and no significant change was found in the parameters mentioned above in group L+K (P＞0.05).Compared with group K,the escape latency was significantly shortened,the time of staying at the original platform quadrant was prolonged,the frequency of crossing the original platform was increased,the expression of GSK3β and NR2A was down-regulated,and the expression of PSD95 was up-regulated in group L+K (P＜0.05).Conclusion Group Ⅱ mGluRs are involved in the process of cognitive decline caused by multiple administrations of ketamine in mice,which is associated with up-regulated expression of hippocampal GSK-3β.

Objective To evaluate the CT features of small lung invasive adenocarcinoma with air?containing space and its relationship with pathological types, and to explore the pathological basis of air?containing space. Methods CT and pathological data of fifty patients with surgically proven lung invasive adenocarcinoma with air?containing space in our hospital from January 2012 to December 2017 were retrospectively reviewed. CT image analysis included image features of tumor and air?containing space. Pathological analysis included pathological subtype, differentiation degree. CT features of tumor and air?containing space were compared with regard to pathological types using chi?square test or Fisher exact text. Analysis of variance was used to compare quantitative data satisfying normal distribution, while those data not satisfying normal distribution were compared with Kruskal?Wallis test. In addition, Spearman correlation was used to analyze the correlation between nodule density and pathological types. Results (1) CT features of tumors: Tumors were predominantly located in peripheral lungs (46/50). Most of the tumors were subsolid nodules (37/50). Tumor?lung interface was generally clear (46/50). Tumors are often accompanied by malignant signs such as lobulation (37/50), spicule sign (27/50), air bronchogram sign (43/50), and pleural indentation (36/50). The mean diameter of nodules ranged from 7.50 mm to 18.12 mm, with an average of (12.91±2.85)mm. The nodule density ranged from-657.00 to 73.00 HU with an average of (-213.88±206.16) HU. (2) CT features of air?containing space:Air?containing spaces were commonly solitary (37/50) and were found to be mainly in an eccentric distribution (29/37). The maximum diameter of air?containing space ranged from 1.00 to 16.00mm, and the average diameter was (4.23±3.14)mm. Air?containing spaces less than 5mm were found in 35 cases (70%), and air?containing spaces more than 5mm were found in 15 cases. (3) Comparison of CT features and corresponding pathological types: Nodule density, number of air?containing space, and type of nodule density in different pathological types were statistically different (P<0.05). There was a correlation between nodule density and pathological subtypes (r=0.371, P=0.008). Differences of nodule density, short?dimension of nodule, type of nodule density, spicule sign, pleural indentation among different tumor differentiation degrees were significant (P<0.05). The degree of tumor differentiation was negatively correlated with nodule density (r=-0.451, P=0.001). Conclusion The detection rate of air?containing space in lung invasive adenocarcinomas is 12.7%. Most small lung invasive adenocarcinomas with air?containing space are presented as peripheral subsolid nodule, and there is a certain correlation between their CT features and pathological types. The pathological basis of air?containing space was supposed to be dilated distal bronchiole induced by check?valve mechanism and destruction of alveolar structure by tumor.

Objective:To evaluate the effect of perioperative transcutaneous electrical acupoint stimulation (TEAS) on postoperative cellular immune function in the patients undergoing posterior spinal internal fixation.Methods:Ninety patients, aged 40-70 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing elective posterior spinal internal fixation in our hospital, were divided into 2 groups ( n=45 each) using a computer-generated table of random numbers: routine group and experiment group.Total intravenous anesthesia was used in routine group, while total intravenous anesthesia combined with TEAS was applied in experiment group.In experiment group, bilateral Zusanli and Sanyinjiao acupoints were stimulated with 2/15 Hz disperse-dense waves at the intensity that could be tolerated by patients at 30 min before induction of anesthesia, maintaining with 2/100 Hz disperse-dense waves from the end of induction until the end of operation at the same stimulation intensity before induction.Bilateral Neiguan and Taichong acupoints were stimulated for 30 min each time with 2/15Hz disperse-dense waves once a day at 1st-4th days after operation.In routine group, the electrodes were connected at the same time period, but no stimulation was given.Venous blood samples were collected before induction of anesthesia, at 1 h after surgery, and on 1st, 3rd, and 5th days after surgery, and the percentage of CD3 + , CD4 + , CD8 + T lymphocytes, CD4 + /CD8 + ratio, WBC count and percentage of neutrophils (NE%) were determined by flow cytometry, and the consumption of intraoperative anesthetics, use of postoperative analgesics, nausea and vomiting, dizziness, infection and length of hospital stay were recorded. Results:Compared with routine group, the total consumption and consumption index of remifentanil were significantly decreased, the percentage of CD3 + T lymphocytes was increased on 3rd and 5th postoperative days, the NE% was decreased on 1st postoperative day, and the incidence of dizziness was decreased ( P<0.05), and no significant change was found in the other indicators in experiment group ( P>0.05). Conclusions:Perioperative TEAS can improve postoperative cellular immune function and has a certain potential value in preventing postoperative infection in the patients undergoing posterior spinal internal fixation.

Objective:To preliminarily investigate the effect of circIGF2BP3 on autophagy in photoaged dermal fibroblasts.Methods:Human dermal fibroblasts were isolated from circumcised foreskin tissues from 6 children in the Department of Urological Surgery, Third Affiliated Hospital of Sun Yat-sen University. An ultraviolet A (UVA) -induced photoaged human dermal fibroblast model (UVA radiation group) was established by repeated UVA radiation at a dose of 10 J/cm 2 for 14 consecutive days, and human dermal fibroblasts receiving no treatment served as control group. The photoaged cell model was verified by β-galactosidase staining, Western blot analysis for determining P21 protein expression, and cell counting kit-8 (CCK8) assay for evaluating cell viability. Moreover, Western blot analysis was performed to determine the protein expression of autophagy-related proteins P62, microtubule-associated protein 1 light chain 3 (LC3) -Ⅰand LC3-Ⅱ in photoaged human dermal fibroblasts, and real-time quantitative RCR (qRT-PCR) to verify the differential expression of circIGF2BP3 between photoaged and normal human dermal fibroblasts. Furthermore, circIGF2BP3 was biologically annotated. Some cultured primary human dermal fibroblasts were divided into 4 groups: empty vector group transfected with an empty vector, UVA + empty vector group transfected with an empty vector followed by repeated UVA radiation, circIGF2BP3 group transfected with a circIGF2BP3-overexpressing lentiviral vector, UVA + circIGF2BP3 group transfected with a circIGF2BP3-overexpressing lentiviral vector followed by repeated UVA radiation. Western blot analysis was performed to determine the expression of autophagy-related proteins. Statistical analysis was carried out by using t test, one-way analysis of variance and least significant difference- t test. Results:Compared with the control group, the UVA radiation group showed significantly increased proportions of β-galactosidase-positive cells (61.33% ± 5.78% vs. 6.37% ± 0.32%, t = 9.49, P < 0.01) and P21 expression (1.25 ± 0.03 vs. 1.00 ± 0.05, t = 4.26, P < 0.05), but significantly decreased cell viability (74.33% ± 3.48% vs. 100%, t = 7.38, P < 0.01). Moreover, the P62 expression and LC3-Ⅱ/Ⅰ ratio were significantly higher in the UVA radiation group than in the control group (both P < 0.05). The relative expression of circIGF2BP3 was 0.72 ± 0.04 in the photoaged human dermal fibroblasts, which was significantly lower than that in the normal human dermal fibroblasts (1.00 ± 0.03, t = 5.46, P < 0.01). The P62 expression and LC3-Ⅱ/Ⅰ ratio were significantly lower in the circIGF2BP3 group (0.60 ± 0.01, 0.71 ± 0.01, respectively) than in the empty vector group (1.00 ± 0.02, 1.00 ± 0.01, t = 16.25, 2.75, P < 0.01, < 0.05, respectively), and lower in the UVA + circIGF2BP3 group (1.05 ± 0.02, 2.04 ± 0.05, respectively) than in the UVA + empty vector group (1.31 ± 0.02, 2.72 ± 0.14, t = 10.493, 6.472, respectively, both P < 0.01) . Conclusion:circIGF2BP3 can regulate autophagy in UVA-induced photoaged dermal fibroblasts, which provides a new potential therapeutic target for the prevention and treatment of skin photoaging.

Objective:To systematically review the teaching effect of problem-based learning (PBL) combined with evidence-based medicine (EBM) teaching mode on the standardized residency training.Methods:CNKI, Wanfang database, VIP database, SinoMed, Embase, PubMed and Web of SCI databases were searched, and the randomized controlled trial (RCT) studies of the application of EBM combined with PBL teaching in standardized residency training were collected. The retrieval time was from the establishment to 1st July, 2018. Two investigators independently extracted data and assessed the quality of the studies. After assessing the risk of bias of included studies, Meta-analysis was performed on RevMan 5.3.Results:In total, 4 studies were included in the review. Narrative assessment was adopted, because outcome indicators of these study were varied and the quality of the literatures could not meet the requirement of Meta-analysis. Our study suggested that the residents who were in PBL combined with EBM teaching mode group got higher scores in the standardized residency training, compared with those in the lecture-based learning (LBL) teaching mode group, especially in case analysis score, total score of examination, improvement of clinical thinking ability, communication and expression ability, organization and cooperation ability, etc.Conclusion:The current evidence suggests that the application of EBM combined with PBL teaching mode has a positive effect on the standardized residency training. Compared with the traditional LBL teaching, EBM can improve students' ability. However, limited by the quantity and quality of included studies, the above conclusions still need to be verified by more studies with larger samples and higher quality.