Objective To evaluate the biological effect of tumor necrosis factor-α(TNF-α) on the proliferation and multi-directional differentiation of stem cells from rat apical papilla(SCAP).Methods SCAP was extracted by combining enzyme digestion method with tissue block method.The cells were divided into control group(TNF-α 0 ng/mL) and experimental group(TNF-α 5,10,20,50 ng/mL).The ability of proliferation of SCAP was measured by MTT method.The ability of osteogenic/dentinogenic differentiation of SCAP was measured by alizarin red staining and quantitative real-time PCR.The ability of adipogenic of SCAP was measured by oil red O staining.The expression of vascular related genes of SCAP was measured by quantitative real-time PCR.Results SCAP was consistent with the characteristics of mesenchymal stem cells and possessed the ability of multi-directional differentiation.The MTT results showed that experimental group promoted the proliferation of SCAP in comparison with the control group.The difference was statistically significant(P<0.05),and 10 ng/mL was the optimum concentration.The results of alizarin red staining showed that with the increase of the concentration of TNF-α,the mineralized nodules in the experimental group gradually became smaller,and the number of the formation decreased gradually.The results of quantitative real-time PCR showed that the expression of OC,DMP-1 and DSPP in the experimental group was significantly lower than that of the control group at 3 and 7 days,in which the expression of OC was statistically significant different(P<0.05);at 14 days,the expression of OC,DMP-1 in the experimental group was significantly lower than that of the control group(P<0.05).The result of Oil red O staining showed that with the increase of the concentration of TNF-α,the lipid droplets formation in the experimental group gradually decreased.The result of quantitative real-time PCR showed that the expression of ANGPT1,VEGFA,PECAM-1 in the experimental group was significantly lower than that of the control group(P<0.05).Conclusion TNF-α might promote the proliferation and inhibit the multi-directional differentiation of SCAP.

Objective To study the comorbidity of somatic dis e ases and its significance among patients of psychiatric department of geriatrics . Methods The data about psychiatric diagnoses, co-existing so matic diseases and curative efficacy of mental diseases were investigated among 198 patients. Results 91.4% of patients co-existed somatic diseases, and the m ean of sort of somatic diseases among each patient was 1.65. Somatic diseases ma inly included pulmonary infection, cerebral vascular disease (CVD), hyper tension, heart disease, diabetes mellitus (DM) and chronic obstructed pulmonary disease (COPD), etc. By logistic regression, it was found that Alzheimer's disea se (AD), the numbers of somatic diseases and co-existing CVD w ere disadvantageous factors of the curative efficacy of mental diseases. Conc lusions The comorbidity of somatic diseases is common among patients of psychiatric department of geriatrics and it affects treatments and curative eff icacy of mental diseases. Furthermore, the comorbidity influences the clinical m odel of psychiatric department of geriatrics.

BACKGROUND:Due to the complexity and irregularity of bypass obturation of oval root canal and the particular stress of the post and core to the tooth, we have not yet found a reasonable post crown for dental restoration after bypass obturation of the oval root canal.
OBJECTIVE:To compare the flexural capacity of the three kinds of post-and-core repair systems (cobalt-chromium cast post and core, zirconium oxide post and core, and CAD/CAM-fabricated glass fiber post and core) after bypass obturation of the oval root canal warm gutta.
METHODS: Ninety mandibular first premolars were selected for bypass obturation of the root canal with Obtura II & System B, and then randomized into three groups that were respectively restored with cobalt-chromium cast post and core, zirconium oxide post and core and CAD/CAM-fabricated glass fiber post and core. After that, cobalt-chromium metal crown was used for ful-crown restoration. Fracture strength and fracture type were recorded in different groups.
RESULTS AND CONCLUSION: The fracture resistance was higher in the cobalt-chromium cast post and core group and zirconium oxide post and core group than the glass fiber post and core group (P < 0.05), and the former two groups had no significant difference. Cobalt-chromium cast post and core was fractured at the root of tooth, and could not be repaired; the zirconium oxide post and core was fractured at the root neck and root of tooth, which was confirmed as reparative fracture; the glass fiber post and core was fractured at the tooth neck, which could be restored. These findings indicate that the cobalt-chromium cast post and core can bear greater occlusal force, but has a higher probability of root fracture; the CAD/CAM-fabricated glass fiber post and core exhibits a lower probability of root fracture

Objective To investigate the relationship between D-dimer levels and the clinical stage and pathological grade of patients with ovarian cancer.Methods The clinical data of 66 patients with ovarian cancer whose D-dimer had been monitored before surgery were retrospectively analyzed.The relationship between D-dimer levels and the clinical stage,pathological grade was evaluated.Results D-dimer levels before surgery were uncorrelated with the patient's age (r =0.1324,P ＞ 0.05 ).There was significant difference in D-dimer levels between FIGO Ⅰ + Ⅱ patients and FIGO Ⅲ + Ⅳ patients [(377.89 ± 183.85) mg/L vs.(858.03 ± 138.29) mg/L] (t =11.602,P＜0.01).There was significant difference in D-dimer levels between high-moderately differentiated patients and poorly differentiated patients [(463.39 ±246.85) mg/L vs.(784.64 ±265.69) mg/L](t =4.983,P＜0.01).Conclusions D-dimer levels are related with the clinical stage and pathological grade of patients with ovarian cancer.It can predict the harmful biological behaviour of ovarian cancer.

Objective To investigate the effect of patients′ health education needs analysis on health education . Methods One hundred and sixty-four type 2 diabetic patients who met the inclusion criteria and participated diabetes education management voluntarily into the control group and the observation group randomly with 82 cases in each group and the control group lost 2 patients and the observation group lost 3. The control group received traditional education. Based on the control group, the observation group also received patients′ health education needs analysis . The two groups were compared in terms of blood glucose level , diabetes knowledge scale score and self-care behavior. Results After 6 months′management, the patients in the observation group were better than the control group in terms of the blood glucose level, diabetes knowledge scale scores and self-care behavior(P<0.05). Conclusion Patients′health education needs analysis before education can enhance their diabetes knowledge and better self-care behavior , improve diabetic patients′control over blood glucose .

OBJECTIVE: To analyze the differences of sleep respiratory parameters recorded by PSG and synchronous blood pressure measured by ambulatory blood pressure monitor between obstructive sleep apnea (OSA) patients with hypertension (HT) and simple OSA and simple HT; To determine the characteristics of sleep respiratory parameters and blood pressure changes in patient with OSA accompanied HT. METHOD: We chose the patients who were diagnosed simple HT (n=45) and simple OSA (n=50) and OSA with HT (n=56), Compared the sleep respiratory parameters and blood pressure changes between the three groups. Meanwhile the correlations about the sleep respiratory parameters and synchronization blood pressure were analyzed. RESULT: Compared with simple HT and simple OSA, OSA with HT has higher apnea hyponea Index (AHI) (P<0. 001), oxygen desaturation index (ODI), awake index (AI), wake after sleep onset (WASO) and the proportion of non-rapid eyemovement sleepl (N1) in total sleep time(TST), has lower mean arterial oxygen saturation (MSaO2), lowest arterial saturation oxygen (LSaO2), the proportion of slow wave sleep (SWS) and rapid eyemovement sleep (REM) in TST (P<0. 05). There were positive correlations between the systolic/diastolic blood pressure (SBP/ DBP) and AHI, ODI, AI, WASO and N1/TST (P<0. 05). Compared with simple OSA, the mean day systolic blood pressure (dMSP), mean night systolic blood pressure (nMSP), mean day diastolic blood pressure (dMDP), mean night diastolic blood pressure (nMDP) and mean night diastolic blood pressure (nMDP) were significantly decre- sed, meanwhile the difference between the average systolic/diastolic blood pressure day and night were significantly increased after continuous positive airway pressure (CPAP) treatment. OSA with HT has higher There were negative correlations between the SBP/DBP and MSaO2, LSaO2 (P<0. 05). Blood pressure mainly changed in the later sleep stage when the REM phase was increased. Blood pressure changes were characteristic of increasing DBP and decreasing SaO2. CONCLUSION There are significant differences between simple OSA and OSA with HT in the sleep respiratory parameters, which are closely related with changes of blood pressure in sleep stage; AHI is the high risk factor of the OSA with HT. PSG is a effective factor in estimating the OSA accompanied HT course of development and prognosis.
Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Continuous Positive Airway Pressure ; Humans ; Hypertension ; complications ; Polysomnography ; Sleep ; Sleep Apnea, Obstructive ; complications ; diagnosis ; Sleep Stages

Objective:To analyze risk factors for duration of small or medium-sized coronary artery aneurysms (CAA) in children with Kawasaki disease (KD) so as to provide clinical guidance for early and full course treatment.Methods:The clinical data of 68 children diagnosed with KD in the Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical University from January 2018 to January 2021 were retrospectively analyzed.According to duration of CAA, all cases were divided into 2 groups, duration of CAA ≥ 8 weeks group and duration of CAA <8 weeks group.Risk factors associated with CAA duration were screened using univariate analysis, and then independent risk factors for CAA duration in children with KD were analysed using multiple Logistic regression analysis. Results:A total of 68 cases were enrolled in this study.Among these cases, 45 cases (66.18%) were male and 23 cases (33.82%) were female.The onset age was from 3 months to 10 years old, and the median onset age was 1.59 (1.02-3.19). There were 31 cases in the group with CAA duration ≥8 weeks and 37 cases in the group with CAA duration <8 weeks.Univariate analysis showed that patients with the total fever course >10 days[45.16%(14/31 cases) vs.21.62%(8/37 cases)], time of treatment with intravenous immunoglobulin (IVIG)>10 days[54.84%(17/31 cases) vs.16.22%(6/37 cases)], platelet (PLT)>600×10 9/L[32.26%(10/31 cases) vs.10.81%(4/37 cases)], hypersensitive C-reactive protein (HsCRP) >100 mg/L[38.71%(12/31 cases) vs.13.51%(5/37 cases)] (all P<0.05 ) in the group with CAA duration ≥8 weeks were significantly more than those in the group with CAA duration <8 weeks.However, there were no significant differences in gender, age, type of KD, etiology evidence, hormone application, duration of fever before IVIG application, IVIG sensitivity, IVIG application way, urine leukocytes, white blood cells, hemoglobin, percent of neutrophilic granulocyte, erythrocyte sedimentation rate, glutamic-pyruvic transaminase between the 2 groups (all P>0.05). Multivariate Logistic regression analysis showed that the course of IVIG before application >10 days ( OR=6.589, 95% CI: 1.678-25.867, P=0.007)and HsCRP >100 mg/L ( OR=7.949, 95% CI: 1.947-32.461, P=0.004)were independent risk factors for predicting the duration of KD complicated with small and medium-sized CAA ≥8 weeks. Conclusions:The course of IVIG before application >10 days and HsCRP>100 mg/L are independent risk factors for KD complicated with small and medium-sized CAA lasting ≥8 weeks.

Objectives:To analyze the clinical features of juvenile myelomonocytic leukemia (JMML) and investigate the characteristics of diagnosis and treatment of this disease.Methods:The clinical data of seven children patients with JMML who received treatment in The First Affiliated Hospital of Xinxiang Medical University between April 2015 and February 2020 were retrospectively analyzed. The clinical efficacy of different treatments was analyzed.Results:The median age at diagnosis of JMML was 8 months and 4 days for seven children patients. Fever was the principal cause of treatment, and it was mostly accompanied by hepatosplenomegaly. The median value of peripheral blood leukocyte count was 36.1 × 10 9/L, and it was 4.5 × 10 9/L for mononuclear cell count, 88 g/L for hemoglobin level, and 47 × 10 9/L for platelet count. Myeloid immature cells were found in peripheral blood smears of six patients. Chromosome examination results revealed 7-monomer in one patient, and normal karyotype in six patients. Hemoglobin level was increased in six patients. Gene detection results revealed PTPN11+NF1 mutation in one patient, N-RAS mutation in two patients, and K-RAS mutation in one patient. Three patients gave up treatment, three patients received low-intensity chemotherapy , and these six patients died of complicated infection. One patient received allogeneic hematopoietic stem cell transplantation and the patient survived without any event after 14 months of follow-up. Conclusion:The age of JMML onset is low. JMML has poor clinical specificity. Gene detection is helpful for early diagnosis of JMML. Low-intensity chemotherapy can prolong survival period, but it can not improve prognosis. Infection is the principal cause of death in patients with JMML. Hematopoietic stem cell transplantation is the only possible method to cure the disease.