OBJECTIVETo study the clinic presentation, radiology, pathology of recurrent ameloblastoma (RAB).

METHODSAll RAB cases accepted treatment in School of Stomatology of Nanjing University during 1996.1-2008.3 were retrospected. The clinic presentation, the radiological classification and pathological classification were summarized and analyzed.

RESULTSThere were 23 RAB patients during 1996.1-2008.3. 3 patients recurred twice, 20 patients recurred once, and 26 cases were found together. 19 patients were performed conservative surgery while 4 patients were performed radical surgery in the primary treatment; 4 patients were performed conservative surgery and 19 patients were performed radical surgery in the recurrence. The radiological classification included 12 cases multicystic, 6 cases unicystic, and 8 cases extraosseous. The pathological classification included 21 cases follicular ameloblastoma, and 5 cases plexiform ameloblastoma. The multicystic after conservative surgery (11 cases) and extraosseous ameloblastoma after radical treatment (8 cases) were more than others according the radiological classification and treatment.

CONCLUSIONConservative surgery has apparent higher recurrences rate than radical surgery. The follicular ameloblastoma has more aggressive biological behave and is more liable to recurred.

Adult ; Ameloblastoma ; Female ; Humans ; Male ; Neoplasm Recurrence, Local ; Oral Medicine

OBJECTIVE:To study absorption characteristics of naringin in situ single-pass intestinal perfusion model of rats. METHODS:UPLC method was established for the content determination of naringin and naringenin in intestinal perfusion samples of rats. The in situ single-pass intestinal perfusion model of rats was adopted to investigate intestinal(duodenum,jejunum,ileum and colon)absorption and metabolic characteristics [apparent permeability coefficient(Peff),absorptivity,metabolic rate] of naringin(10 μ mol/L). RESULTS:The linear range of naringin and naringenin were 1.25-40,1.25-40 μ mol/L(R2=0.999 4, 0.996 6). The detection limit were 0.5,0.4 μ mol/L,and limit of quantitation were all 1.25 μ mol/L. Precision of inter-day and intra-day,recovery and stability in HBSS solution,perfusion fluid of small intestine and colon were all in line with the standard. Peffof naringin in duodenum,jejunum,ileum and colon of rats were(0.28 ± 0.19),(0.71 ± 0.17),(0.30 ± 0.02),(0.59 ± 0.19) (n=6),without statistical significance(P>0.05).Absorptivities were(2.90±2.14)%,(6.38±3.61)%,(3.69±0.56)%,(6.64± 2.12)%(n=6). Naringin could be metabolized to naringenin in 4 intestinal segments of rats,with metabolic rate of(2.98 ± 1.51)%,(2.53 ± 1.31)%,(2.24 ± 1.33)%,(0.70 ± 0.20)%(n=6). The lowest absorptivity and the highest metabolic rate of naringin were occurred in the duodenum,there were statistical significance compared with colon(P<0.05). CONCLUSIONS:Naringin shows poor permeability and poor absorption in the intestinal tract of rats.There was no specific absorption site in the rat' s intestines for naringenin;naringin could be metabolized to naringenin in small intestine and colon,but metabolic rate of naringin in small intestine is higher than in colon.

Objective The bispectral index (BIS) was introduced into the sedation strategy of critical patients in intensive care unit (ICU) and replaced the Richmond agitation sedation scale (RASS).The ventilation time,ICU length of stay,and 90-day mortality were compared between the two groups of patients who performed early goal-directed sedation (EGDS) or standard traditional directed sedation (STDS) strategies.Methods A prospective controlled study of severe patients with mechanical ventilation ≥48 h in ICU (20 cases from April 2016 to May 2017,46 cases from June 2017 to April 2018) were randomly divided into EGDS or STDS group.There were no significant differences in age,gender,and acute physiology and chronic health evaluation score Ⅱ (APACHE Ⅱ) score between the two groups in the two periods.The correlation between RASS and BIS was analyzed in the first period.The BIS of the patients in a RASS range of (-2-1) was 73.65 ± 7.87 in the EGDS group,and that of RASS range of (-3--1) was 64.14 ± 7.25 in the STDS group.The above BIS was applied to the two sedation strategies in the second period respectively.The ventilation time,ICU length of stay,and 90-day mortality were recorded.Results There was no significant difference in the ventilation time between the two groups [(164.12 ± 137.96) h and (155.33 ±64.86)h,P =0.08].ICU length of stay of the EGDS group was longer than that of the STDS group.The 90-day mortality of the EGDS group was higher than that of the STDS group.Conclusions Correlations between RASS and BIS were found in this study,and BIS can be used for sedation assessment in ICU patients.Large sample study is still needed to compare EGDS and STDS with BIS.

Objective:To construct a predictive nomogram incorporating pretreatment CT-based radiomics for radiation pneumonitis (RP) in esophageal cancer (EC) patients treated with intensity-modulated radiotherapy (IMRT), and to evaluate the value of CT radiomics in predicting RP.Methods:Clinical data of 267 EC patients sequentially treated with IMRT in Quanzhou First Hospital affiliated to Fujian Medical University from January 2019 to December 2021 were prospectively analyzed. Among them, the first 206 patients were assigned into the training cohort and the last 61 patients were enrolled in the validation cohort. Radiomics features of bilateral lungs were extracted by radiotherapy CT simulation. Univariate analysis was performed to screen the potential predictive variables for symptomatic RP. Machine learning algorithms, such as least absolute shrinkage and selection operator (LASSO), extreme gradient boosting (XGboost), and support vector machine (SVM), were performed for radiomic features selection, respectively. The best classifier was chosen to construct a radiomic signature (RS). Clinical, radiomics and combined nomogram predictive model were developed, respectively. The predictive efficiency and clinical benefits of three models were compared by calculating the area under the receiver operating characteristic (ROC) curve (AUC), calibration curve and decision curve analysis (DCA), and then validated in the validation cohort. Multivariate logistic regression analysis was conducted. Different ROC curves were compared by Delong test.Results:Cardiovascular disease, minimum internal diameter of esophagus and adjuvant chemotherapy and RS were the independent related factors of RP. The AUC of clinical, radiomics and combined models were 0.772, 0.745, 0.842 in the training cohort, and 0.851, 0.811, 0.901 in the validation cohort, respectively. DCA showed that combined radiomic model yielded better clinical benefits compared with clinical model.Conclusion:Radiomics features from pretreatment CT have the potential of improving the efficiency of RP prediction models for EC patients treated with IMRT.

Objective To understand the prevalence,treatment and influence factors of hypertension in maintenance hemodialysis (MHD) patients in Anhui Province.Methods A total of 2724 adult patients on MHD from January 1st 2014 to March 31st 2014 in 26 hospitals of southern,northern and central Anhui Province were investigated.Their demographic characteristics,primary disease,complications,medications,dialysis and laboratory examination were explored.The prevalence treatment rate and control rate of hypertension were analyzed.Associated factors for controlling hypertension [systolic blood pressure (SBP) ＜ 140 mmHg and diastolic blood pressure (DBP) ＜ 90 mmHg] were assessed by logistic regression analysis.Results (1) The prevalence of hypertension in the hemodialysis patients was 87.0％.Their treatment rate and control rate were 93.2％ and 23.9％ respectively.The average of SBP was (145.90±21.18) mmHg,and the DBP on average was (83.60± 12.21) mmHg.The most commonly used anti-hypertensive drug is calcium channel blocker (88.2％).Over one third (45.7％) of patients were treated with two kinds of anti-hypertensive drug,26.2％ with 1 kind,21.7％ with 3 kinds,and 6.4％ with 4 kinds or more.(2) Compared with non-hypertension patients,patients with hypertension have older age,higher body mass index (BMI),phosphorus,SBP and DBP,as well as lower hemoglobin and Kt/V (all P ＜ 0.05).(3) The multivariate logistic regression analysis showed that Ca ＞ 2.50 mmol/L (OR=2.084,95％CI 1.008-4.307,P=0.047) positively correlated with controlling hypertension,while smoke (OR=0.594,95％CI 0.356-0.911,P=0.046) and BMI 18.5 ～ 23.9 kg/m2 (OR=0.516,95％CI 0.293-0.907,P=0.022) negatively correlated with it.Conclusions High prevalence yet low control rate of hypertension in MHD patients in Anhui Province were observed.Hypocalcemia may be a protective factor for hypertension control,while smoke and BMI may be risk factors for it.

Production of biofuels such as ethanol from non-grain crops may contribute to alleviating the global energy crisis and reducing the potential threat to food security. Tobacco (Nicotiana tabacum) is a commercial crop with high biomass yield. Breeding of starch-rich tobacco plants may provide alternative raw materials for the production of fuel ethanol. We cloned the small subunit gene NtSSU of ADP-glucose pyrophosphorylase (NtAGPase), which controls starch biosynthesis in tobacco, and constructed a plant expression vector pCAMBIA1303-NtSSU. The NtSSU gene was overexpressed in tobacco upon Agrobacterium-mediated leaf disc transformation. Phenotypic analysis showed that overexpression of NtSSU gene promoted the accumulation of starch in tobacco leaves, and the content of starch in tobacco leaves increased from 17.5% to 41.7%. The growth rate and biomass yield of the transgenic tobacco with NtSSU gene were also significantly increased. The results revealed that overexpression of NtSSU gene could effectively redirect more photosynthesis carbon flux into starch biosynthesis pathway, which led to an increased biomass yield but did not generate negative effects on other agronomic traits. Therefore, NtSSU gene can be used as an excellent target gene in plant breeding to enrich starch accumulation in vegetative organs to develop new germplasm dedicated to fuel ethanol production.
Biomass ; Gene Expression Regulation, Plant ; Plant Breeding ; Plant Leaves/genetics* ; Plants, Genetically Modified/metabolism* ; Starch ; Tobacco/metabolism*

Objective:To evaluate the efficacy and prognostic factors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with myelodysplastic syndrome accompanied by myelodysplasia (MDS-EB) and to compare the prognosis of different subtypes of patients classified by World Health Organization (WHO) 2022.Methods:A total of 282 patients with MDS-EB who underwent allo-HSCT at the Hematology Hospital of the Chinese Academy of Medical Sciences from October 2006 to December 2022 were included in the study. The WHO 2022 diagnostic criteria reclassified MDS into three groups: myelodysplastic tumors with type 1/2 of primitive cell proliferation (MDS-IB1/IB2, 222 cases), MDS with fibrosis (MDS-f, 41 cases), and MDS with biallelic TP53 mutation (MDS-biTP53, 19 cases). Their clinical data were retrospectively analyzed.Results:① The median age of 282 patients was 46 (15-66) years, with 191 males and 91 females. Among them, 118 (42% ) and 164 (58% ) had MDS-EB1 and MDS-EB2, respectively. ②Among the 282 patients, 256 (90.8% ) achieved hematopoietic reconstruction after transplantation, with 11 (3.9% ) and 15 (5.3% ) having primary and secondary implantation dysfunctions, respectively. The cumulative incidence of acute graft-versus-host disease (GVHD) 100 days post-transplantation was (42.6±3.0) %, and the cumulative incidence of grade Ⅱ-Ⅳ acute GVHD was (33.0±2.8) %. The cumulative incidence of chronic GVHD 1 year post-transplantation was (31.0±2.9) %. Post-transplantation, 128 (45.4% ), 63 (22.3% ), 35 (12.4% ), and 17 patients (6.0% ) developed cytomegalovirus infection, bacteremia, pulmonary fungal infection, and Epstein-Barr virus infection. ③The median follow-up time post-transplantation was 22.1 (19.2-24.7) months, and the 3-year overall survival (OS) and disease-free survival (DFS) rates were 71.9% (95% CI 65.7% -78.6% ) and 63.6% (95% CI 57.2% -70.7% ), respectively. The 3-year non-recurrent mortality rate (NRM) is 17.9% (95% CI 13.9% -22.9% ), and the 3-year cumulative recurrence rate (CIR) is 9.8% (95% CI 6.7% -13.7% ). The independent risk factors affecting OS post-transplantation include monocyte karyotype ( P=0.004, HR=3.26, 95% CI 1.46-7.29), hematopoietic stem cell transplantation complication index (HCI-CI) of ≥3 points ( P<0.001, HR=2.86, 95% CI 1.72-4.75), and the occurrence of acute gastrointestinal GVHD of grade Ⅱ-Ⅳ ( P<0.001, HR=5.94, 95% CI 3.50-10.10). ④The 3-year OS and DFS rates in the MDS-IB1/IB2 group post-transplantation were better than those in the MDS-biTP53 group [OS: 72.0% (95% CI 63.4% -80.7% ) vs 46.4% (95% CI 26.9% –80.1% ), P=0.020; DFS: 67.4% (95% CI 60.3% -75.3% ) vs 39.7% (95% CI 22.3% -70.8% ), P=0.015]. The 3-year CIR was lower than that of the MDS-biTP53 group [7.3% (95% CI 4.3% -11.4% ) vs 26.9% (95% CI 9.2% -48.5% ), P=0.004]. The NRM at 3 years post-transplantation in the MDS-IB1/IB2, MDS-f, and MDS-biTP53 groups were 16.7% (95% CI 12.1% -22.1% ), 20.5% (95% CI 9.4% -34.6% ), and 26.3% (95% CI 9.1% -47.5% ), respectively ( P=0.690) . Conclusion:Allo-HSCT is an effective treatment for MDS-EB, with monomeric karyotype, HCI-CI, and grade Ⅱ-Ⅳ acute gastrointestinal GVHD as independent risk factors affecting the patient’s OS. The WHO 2022 classification helps distinguish the efficacy of allo-HSCT in different subgroups of patients. Allo-HSCT can improve the poor prognosis of patients with MDS-f, but those with MDS-biTP53 have a higher risk of recurrence post-transplantation.