Objective:To compare the osteogenic differentiation of dental pulp stem cells(DPSCs)induced by osteopontin(OPN)and mineralizing culture medium(MCM).Methods:DPSCs were cultured with OPN(OPN group)and MCM(MCM group)respectively. The morphology of the DPSCs were observed under inverted microscope.The mineralize nodules were observed by alizarin red staining. RT-RCR was used to detect the mRNA expression of bone sialoprotein (BSP),Runt-related transcription factor 2(Runx-2),osteocal-cin(OCN)and collagen-1(Col-1).Results:Similar number of mineralized nodules was found in the 2 groups(P >0.05)after 28 day culture.The mRNA expression level of BSP gene in OPN group was higher than that in MCMgroup(0.864 ±0.112 and 0.514 ±0.068, P <0.05),while the expression level of Runx-2 gene in OPN group is lower than that in MCMgroup(0.186 ±0.017 and 0.324 ±0. 058,P <0.05).The expression level of Col-1 and OCN genes in both groups were similar(P >0.05).Conclusion:The capabilities of OPN and MCMin inducing osteogenic differentiation of DPSCs are similar.

Objective:To observe the technique of using the random flap with a subcutaneous pedicle forone-stage reconstuction of anterior auricular conchal defect and its efficancy.Methods:Ten cases were involved in this study, including 3 cases of carcinoma, 6 cases of nevus, and one with iatrogenic detect. Six patients were men, and 4 were women. Their ages were 2 months to 68 years (mean 57 years). Surgical defect size ranged from 1.0 cm×1.0 cm to 2.5 cm×1.5 cm. They were resected and reconstructed using the retroauricular random flap of the subcutaneous pedicle.Results:10 wounds were healed by first intention. The appearance and functionality of the flap matched well with the receiptive site. During 6 to 24 months of follow-up, no tumor or nevus recurred. All patients were satisfied with the aesthetic results of the POSAS assessment scale.Conclusions:Aesthetic results are achieved with satisfactory appearance and functionality by this easy-to-learn technique in comparative short surgical time.

Magnesium sulfate has been administered to pregnant women at imminent risk of preterm delivery for fetal neuroprotection, but its adverse effects and target population have not been fully studied. This paper summarizes the current protocols according to the existing guidelines and the latest research progress, including the gestational age at intervention, dose, duration of therapy and the need for re-administration, hoping to provide a reference for the clinical use of magnesium sulfate for fetal neuroprotection in China.

Objective:To analyze the clinical features, prevention, and treatment of diabetic ketoacidosis (DKA) in pregnancy.Methods:Clinical features, treatment, and pregnancy outcomes of ten pregnant patients diagnosed with DKA and treated at Peking University First Hospital from January 2004 to December 2021 were analyzed retrospectively using descriptive statistical analysis.Results:DKA was found in two cases in the first trimester, three in the second trimester, and five in the third trimester, respectively. Six had type 1 diabetes (including two patients with fulminant type 1 diabetes) and four patients had type 2 diabetes. Only two cases received regular pregnancy examinations, and two began prenatal care in the second trimester. The other six cases neither had prenatal examination nor regular examination. Infection, pancreatitis, and preeclampsia occurred in six, two, and one case, respectively, and among them, four had urinary system infection. Laboratory examination showed that the average pH, blood glucose, and glycated hemoglobin A1c (HbA1c) at onset were 7.06±0.16, (23.7±2.6) mmol/L and (9.2±0.8)%. All patients had different degrees of electrolyte disorder and tested positive for urine ketone bodies. After rehydration, glucose-lowering, and correction of electrolyte disorder, the acidosis was relieved, and the ketone bodies turned negative in all patients. There was no maternal death. The fetal loss occurred in five cases, including one with intrauterine fetal death in late pregnancy, one with embryo arrest in early pregnancy, one with unavoidable abortion, and two terminated on maternal request. The remaining three were term labor and two were preterm labor.Conclusions:The leading cause of DKA in pregnancy is poor control of diabetic blood glucose, followed by infection. Once DKA is complicated during pregnancy, the outcome of the mother and her baby is poor. Its occurrence should be actively prevented. For women with fulminant type 1 diabetes, DKA is easier to occur, and the prognosis is poorer, so strict management and follow-up should be warranted.

Objective To investigate the protective effect of thalidomide on acute lung injury (ALI) induced by paraquat (PQ) poisoning in rats and its possible mechanism. Methods Sixty SPF Wistar rats were randomly divided into six groups with 10 rats in each group. The rat model of PQ poisoning was reproduced by intraperitoneal injection of PQ solution 20 mg/kg (PQ model group), and the rats were treated by intraperitoneal injection of gradient thalidomide (50, 100, 200 mg/kg treatment groups) 30 minutes later continuously for 3 days. The normal saline (NS) control group and thalidomide control group (thalidomide 200 mg/kg) were established. After 3 days, the abdominal aorta blood was collected, and the superoxide dismutase (SOD) activity was determined by hydroxylamine method, serum malondialdehyde (MDA) content was determined by thiobarbituric acid method. The rats were sacrificed for lung tissue, the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA). The phosphorylation levels of p65 and inhibitor-α of nuclear factor-κB (NF-κB) (IκB-α), which were the NF-κB signaling pathway proteins, were determined by Western Blot. The pathological changes in lung tissue were observed under light microscope by hematoxylin-eosin (HE) staining. Results Under microscope, obvious congestion of pulmonary interstitial and alveolar septum, a large number of inflammatory cells infiltration and thickened alveolar wall were observed after 3 days of PQ poisoning, and the congestion of pulmonary interstitial and alveolar septum, edema and inflammatory cells infiltration in the lung tissue were significantly reduced after treatment of 50, 100, 200 mg/kg thalidomide, but compared with NS control group, there was still a small amount of edema fluid, inflammatory cells and erythrocytes in the lungs tissue. Compared with the NS control group, serum MDA content and the levels of TNF-α and IL-6, and the phosphorylation of p65 and IκB-α in lung tissue were significantly increased after PQ exposure, and the activity of serum SOD was significantly decreased. Treatment with 50, 100, 200 mg/kg thalidomide could significantly reduce the levels of MDA, TNF-α, IL-6, and phosphorylation of IκB-α and p65, and increase SOD activity, in a dose-dependent manner, and the levels were significantly different from PQ model group [MDA (mmol/L): 8.26±1.20, 6.72±1.18, 5.51±1.44 vs. 9.02±1.03, TNF-α (ng/mg): 3.00±0.14, 1.84±0.18, 1.58±0.11 vs. 3.30±0.14, IL-6 (ng/mg): 1.26±0.04, 1.06±0.04, 0.97±0.08 vs. 1.97±0.07, p-p65/p65: 6.01±0.35, 3.64±0.15, 2.89±0.18 vs. 6.34±0.23, p-IκB-α/IκB-α: 2.27±0.13, 2.14±0.22, 1.52±0.14 vs. 2.96±0.20, SOD (kU/L): 195.7±19.3, 207.1±25.6, 225.8±23.1 vs. 188.2±26.6, all P < 0.05]. There was no significant effect on lung by 200 mg/kg thalidomide alone. Conclusion Thalidomide has a protective effect on ALI induced by PQ poisoning in rats in a dose-dependent manner, the mechanism may be achieved by reducing the level of oxygen free radicals, reducing the inflammatory factor and inhibiting the IκB-α/NF-κB signal pathway activation.

Objective To investigate the effects of Wnt3a protein on proliferation and osteogenic differentiation of human dental pulp stem cells(DPSC). Methods Intact human permanent teeth extracted for orthodontic reasons were collected and used as study models. The biological effects of Wnt3a on DPSC were investigated using methyl thiazolyl tetrazolium(MTT), alkaline phosphatase(ALP) activity assay, alizarin red S staining and realtime fluorescence quantitative PCR. Osteogenic-related gene expression of induced DPSC was examinedby using tests of bone sialoprotein(BSP), osteocalcin(OCN), collagen typeⅠ(COL-Ⅰ) and Runt-related transcription factor 2(RUNX-2). Results Wnt3a proteininduced an increase of cell growth and treatment of DPSC with Wnt3a induced a highest increase in cell growth at the concentration of 5μg/L. 5 μg/L Wnt3a proteins combined with the osteogenic medium treatment caused up-regulated osteogenic differentiation, ALP activity and express of osteogenic-related genes of DPSC, and the ALP activity(0.47 ± 0.04) was significantly stronger than the other groups(osteogenic medium: 0.39 ± 0.05;20μg/L:0.34 ± 0.03;50 μg/L: 0.27 ± 0.07; 100 μg/L: 0.20 ± 0.03). Conclusions Exogenous Wnt3a protein treatment on DPSC could affect the proliferation and osteogenic differentiation.

Background::Alterations in the placental expression of glucose transporters (GLUTs), the crucial maternal-fetal nutrient transporters, have been found in women with hyperglycemia in pregnancy (HIP). However, there is still uncertainty about the underlying effect of the high-glucose environment on placental GLUTs expression in HIP.Methods::We quantitatively evaluated the activity of mammalian target of rapamycin (mTOR) and expression of GLUTs (GLUT1, GLUT3, and GLUT4) in the placenta of women with normal pregnancies (CTRL, n = 12) and pregnant women complicated with poorly controlled type 2 diabetes mellitus (T2DM, n = 12) by immunohistochemistry. In addition, BeWo cells were treated with different glucose concentrations to verify the regulation of hyperglycemia. Then, changes in the expression of GLUTs following the activation or suppression of the mTOR pathway were also assessed using MHY1485/rapamycin (RAPA) treatment or small interfering RNA (siRNA)-mediated silencing approaches. Moreover, we further explored the alteration and potential upstream regulatory role of methyltransferase-like 3 (METTL3) when exposed to hyperglycemia. Results::mTOR, phosphorylated mTOR (p-mTOR), and GLUT1 protein levels were upregulated in the placenta of women with T2DM compared with those CTRL. In BeWo cells, mTOR activity increased with increasing glucose concentration, and the expression of GLUT1, GLUT3, and GLUT4 as well as GLUT1 cell membrane translocation were upregulated by hyperglycemia to varying degrees. Both the drug-mediated and genetic depletion of mTOR signaling in BeWo cells suppressed GLUTs expression, whereas MHY1485-induced mTOR activation upregulated GLUTs expression. Additionally, high glucose levels upregulated METTL3 expression and nuclear translocation, and decreasing METTL3 levels suppressed GLUTs expression and mTOR activity and vice versa. Furthermore, in METTL3 knockdown BeWo cells, the inhibitory effect on GLUTs expression was eliminated by activating the mTOR signaling pathway using MHY1485. Conclusion::High-glucose environment-induced upregulation of METTL3 in trophoblasts regulates the expression of GLUTs through mTOR signaling, contributing to disordered nutrient transport in women with HIP.

Objective:To explore the causes of self-management dilemma in young and middle-aged patients with recurrent acute pancreatitis from the perspectives of nurses, patients and patient caregivers, in order to provide reference for developing self-management intervention plans that meet the needs of patients.Methods:Using the descriptive phenomenological methods from qualitative research, 15 patients with recurrent acute pancreatitis, six nurses and nine caregivers from the Hepatobiliary Pancreatic Surgery Ward of the Second Norman Bethune Hospital of Jilin University from November 2021 to December 2022 were selected for semi-structured in-depth interviews. The Colaizzi 7-step method was used to analyze and refine the theme.Results:Two main themes were extracted to explain the difficulties in self-management of young and middle-aged patients with recurrent acute pancreatitis. The internal reasons for the self-management dilemma included cognitive biases in the importance of self-management, limited access to self-management knowledge and negative attitudes towards self-behavior management, and the external reasons for self-management dilemma included insufficient inclusiveness of the external environment towards diseases, fear of disease progression, multiple burdens caused by diseases and busy work.Conclusions:Young and middle-aged patients with recurrent acute pancreatitis experience multiple difficulties in the process of self-management. Clinical medical staff should explore self-management models with contemporary characteristics, enhance patient self-management ability and quality of life, reduce disease recurrence rate.

Objective:To investigate the repair of the severe nasal deformity in the unilateral cleft lip secondary with the methods in the composite tissue Z-plasty and the nasolabial anatomical reconstruction.Methods:A total of 25 patients with severe nasal deformity due to secondary unilateral cleft lip underwent the reconstructive surgery using the technique of composite tissue Z-plasty and the nasolabial anatomical reconstruction for anatomical restoration of cartilage, muscle, and soft tissue layers. All patients were followed up for 3-24 months, with an average period of 7.6 months. The treatment outcomes were evaluated by a questionnaire in postoperative follow-up.Results:All the 25 patients had achieved satisfactory nostril shape and no other complications such as bleeding, infection and flap necrosis were recorded. A total of 25 patients were evaluated postoperatively. The average columella length was significantly improved from an average of 14.2 mm preoperatively to 20.2 mm postoperatively. The average ratio of the cleft side columella height to the alar base width was 0.18 preoperatively and 0.30 postoperatively. The postoperative basal and frontal views revealed a better shape of the nostrils, columella and nasal floor. GAIS questionnaires of 25 patients demonstrated that 20 patients reported great improvement, 4 patients reported moderate improvement, 1 patient had poor improvement in size and shape of the affected side nostril who undevwent the another repair of the rdure in 12 months postoperation. The ectopic muscles around the pear hole was completely released and the effect was good after repair. The satisfactory rate was 96%.Conclusions:Combining the composite tissue Z-plasty with the nasolabial anatomical reconstruction allows for thorough anatomical restoration of cartilage, muscle, and skin layers in unilateral cleftlip nasal deformities. This single-step approach is a safe and technically easy therapeutic option that is associated with high patients′ satisfaction. This method should be considered for promotion in clinic.

Objective:To explore the ideal way of using the stereoscopic unequal S-plasty in reconstruction of the congenital hypoplastic ear lobe cleft with soft tissue deficiency.Methods:Data of 10 patients with the congenital hypoplastic ear lobe cleft associated with soft tissue deficiency who were treated using the stereoscopic unequal S-plasty in the plastic cosmetic surgery of Xuzhou Central Hospital from Aug 2018 to Aug 2022 were retrospectively analyzed. Six patients were male, 4 were female. Their ages ranged from 6 years to 19 years old, with a mean age of 13 years. Lobe deficiency size ranged from 0.8 cm×0.5 cm to 1.2 cm×1.0 cm.Results:The post-operation flaps had no venous congestion, infection or necrosises. During 3 to 12 months of follow-up, the technique made the shape of the ear lobe smoother. The incisions left inconspicuous scars. The result was satisfactory in terms of matching the contralateral normal ear lobe in shape and symmetry. Doctors and patients were satisfied with the results.Conclusions:The stereoscopic unequal S-plasty is an effective way to correct the the severe congenital ear lobe deformity. The good result,simple manipulation and short operation time are the advantages of this method.