Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

Acute respiratory distress syndrome is one of the common complications of sepsis syndrome, belonging to the "Chuan syndrome", "Baochuan", and "Chuantuo" in the TCM field, and the disease is mainly located in the lung. The main etiology and pathogenesis of sepsis syndrome is deficient healthy qi and blood stasis with toxin blocking collaterals. Blood stasis and toxin invade the lung, causing heat and toxin to burn the body fluid in the blood. Blood viscosity and poor circulation lead to the accumulation of blood stasis and toxin in the lung. Acute deficiency syndrome, heat toxin damaging qi, heat toxin burning body fluid deficiency with little ability to dissipate qi, resulting in deficiency of healthy qi, inability to regulate breathing, inability to consolidate body fluid, inability to promote blood circulation, causing phlegm, dampness, and blood stasis blocking the lung. This disease is characterized by blood stasis with toxin blocking collaterals, deficient lung qi, and obstruction of lung qi caused by phlegm, water, dampness, and blood stasis. Therefore, blood stasis with toxin blocking collaterals, as well as deficient healthy qi are TCM pathogenesis of ARDS with sepsis syndrome.

Objective:To systematically analyze the influencing factors of stigma in patients with stoma, so as to provide evidence-based basis for clinical formulation of effective interventions.Methods:We systematically searched Chinese and English databases such as China National Knowledge Infrastructure (CNKI), Chinese Citation Database, WanFang Data, VIP, SinoMed, PubMed, Web of Science, Cochrane Library, Embase, and carried out manual search. The retrieval time limit was from the establishment of the database to June 1, 2022. RevMan5.3 software was used to conduct meta-analysis of data.Results:A total of 17 articles including 2 900 patients were included. Meta-analysis showed that age [ OR=0.51, 95% CI (0.28, 0.92) ], residence [ OR=3.08, 95% CI (1.87, 5.06) ], stoma leakage frequency [ OR=5.81, 95% CI (3.53, 9.55) ], self-care [ OR=0.60, 95% CI (0.41, 0.90) ], stoma acceptance [ OR=0.12, 95% CI (0.07, 0.22) ], communication with medical and nursing staff [ OR=0.33, 95% CI (0.20, 0.55) ], participation in stoma activities [ OR=0.25, 95% CI (0.10, 0.63) ], stoma type [ OR=4.04, 95% CI (2.33, 7.02) ], spouse's acceptance of stoma [ OR=0.19, 95% CI (0.06, 0.58) ], nursing privacy [ OR=0.13, 95% CI (0.05, 0.32) ], family relationship [ OR=0.09, 95% CI (0.04, 0.19) ], faecal leakage [ OR=8.20, 95% CI (4.60, 14.63) ], self-concealment [ OR=0.81, 95% CI (0.76, 0.85) ], yield [ OR=0.57, 95% CI (0.27, 0.77) ], dependence on professionals and relatives [ OR=0.26, 95% CI (0.14, 0.39) ], depression [ OR=0.65, 95% CI (0.52, 0.75) ], self-esteem [ OR=0.44, 95% CI (0.37, 0.51) ], social support [ OR=-0.63, 95% CI (-0.67, -0.59) ], confrontation [ OR=-0.46, 95% CI (-0.66, -0.22) ], self-efficacy [ OR=-0.57, 95% CI (-0.71, -0.39) ]were the influencing factors of stigma in patients with stoma ( P<0.05). In contrast, gender, education, average monthly household income, stoma complications, degree of impact on sexual life, whether body image has changed, acceptance of stoma by family members other than spouse, and avoidance had no effect on the level of stigma of stoma patients, and the differences were not statistically significant ( P>0.05) . Conclusions:There are many factors influencing the stigma of patients with stoma. Medical and nursing staff should identify high-risk groups as early as possible according to the influencing factors, and formulate targeted interventions to reduce the stigma of patients with stoma.

Pichia pastoris is one of the most widely used recombinant protein expression systems. In this study, a novel method for rapid screening of P. pastoris strains capable of efficiently expressing recombinant proteins was developed. Firstly, the ability to express recombinant proteins of the modified strain GS115-E in which a functional Sec63-EGFP (Enhanced green fluorescent protein) fusion protein replaced the endogenous endoplasmic reticulum transmembrane protein Sec63 was tested. Next, the plasmids carrying different copy numbers of phytase (phy) gene or xylanase (xyn) gene were transformed into GS115-E to obtain recombinant strains with different expression levels of phytase or xylanase, and the expression levels of EGFP and recombinant proteins in different strains were tested. Finally, a flow cytometer sorter was used to separate a mixture of cells with different phytase expression levels into sub-populations according to green fluorescence intensity. A good linear correlation was found between the fluorescence intensities of EGFP and the expression levels of the recombinant proteins in the recombinant strains (0.8<|R|<1). By using the flow cytometer, high-yielding P. pastoris cells were efficiently screened from a mixture of cells. The expression level of phytase of the selected high-fluorescence strains was 4.09 times higher than that of the low-fluorescence strains after 120 h of methanol induction. By detecting the EGFP fluorescence intensity instead of detecting the expression level and activity of the recombinant proteins in the recombinant strains, the method developed by the present study possesses the greatly improved performance of convenience and versatility in screening high-yielding P. pastoris strains. Combining the method with high-throughput screening instruments and technologies, such as flow cytometer and droplet microfluidics, the speed and throughput of this method will be further increased. This method will provide a simple and rapid approach for screening and obtaining P. pastoris with high abilities to express recombinant proteins.
6-Phytase/genetics* ; Pichia/genetics* ; Plasmids ; Recombinant Proteins/genetics* ; Saccharomycetales

Objective:To investigate the effect of pidotimod in reducing pulmonary infection in patients with lung cancer undergoing chemotherapy.Methods:One hundred and twenty patients with lung cancer in the Fifth People′s Hospital of Dalian City from July 2017 to July 2018 were selected. The patients were divided into control group and pidotimod group by random digits table method with 60 cases each. The patients were treated with standard two drugs chemotherapy containing platinum drug according to the pathological type, and the patients in pidotimod group were combined with pidotimod. The number of pulmonary infections during chemotherapy, number of completed scheduled chemotherapy and adverse reaction were observed. The correlation between pulmonary infection and pidotimod was analyzed by multivariate orderly Logistic regression.Results:The incidence of pulmonary infection in pidotimod group was significantly lower than that in control group: 18.33% (11/60) vs. 40.00% (24/60), and there was statistical difference ( χ2 = 6.845, P<0.01). The rate of completed scheduled chemotherapy in pidotimod group was significantly higher than that in control group: 55.00% (33/60) vs. 36.67% (22/60), and there was statistical difference ( χ2 = 4.062, P<0.05). Multivariate orderly Logistic regression analysis result showed that pidotimod could reduce the risk of pulmonary infection ( OR = 0.210, 95% CI 0.072 to 0.606, P = 0.004), and help to complete the scheduled chemotherapy ( OR = 2.323, 95% CI 1.080 to 5.003, P = 0.031). In pidotimod group, no obvious adverse reaction related to pidotimod application was detected, and chemotherapy was not affected. Conclusions:Application of pidotimod can reduce the chance of pulmonary infection in patients with lung cancer undergoing chemotherapy and help patients complete scheduled chemotherapy.

Objective:To understand the level of iodine nutrition in the areas with iodine deficiency and high iodine in Anyang City of Henan Province, and to provide a basis for taking targeted prevention and treatment measures and scientific adjustment of intervention strategies.Methods:In 2019, three areas with iodine deficiency (median iodine in water < 10 μg/L) and three areas with high water iodine (median iodine in water > 100 μg/L) were selected from counties (cities and districts) in Anyang City by stratified random sampling. Children aged 8-10 and pregnant women were selected in areas with high iodine and areas with iodine deficiency, respectively. Urine samples and salt samples were collected and tested, and children's thyroids were examined by B-mode ultrasound.Results:A total of 654 salt samples were collected in iodine deficiency areas, among which non-iodized salt accounted for 1.83% (12/654). A total of 628 salt samples were collected from areas with high iodine, among which non-iodized salt accounted for 6.05% (38/628). The difference in non-iodized salt rate between the two areas was statistically significant (χ 2=15.19, P < 0.05). A total of 654 urine samples were collected from children in iodine deficiency areas, with a median of 211.15 μg/L of urinary iodine, and 628 urine samples were collected from high iodine areas, with a median of 390.50 μg/L of urinary iodine. The difference was statistically significant ( U=- 18.34, P < 0.05). A total of 300 urine samples were collected from pregnant women in iodine deficiency areas, with a median of 223.95 μg/L, and 127 urine samples were collected from pregnant women in high iodine areas, with a median of 258.00 μg/L. The difference was statistically significant ( U=- 4.07, P < 0.05). The thyroid volume of 560 children in the iodine deficient areas was detected, and the swelling rate was 1.43% (8/560). The thyroid volume of 628 children in high iodine areas was detected, and the swelling rate was 2.07% (13/628). Conclusion:The iodine nutrition level of the population in the iodine deficiency areas of Anyang City is appropriate, while the iodine nutrition level of the population in the water source high iodine areas is excessive.

Objective:To investigate the brain characteristics of chronic schizophrenia by voxel-mirrored homotopic connectivity (VMHC).Methods:Forty seven patients with chronic schizophrenia from Tianjin Anding Hospital and 31 healthy controls from nearby communities were included in the study. The MRI data of the subjects were collected by Siemens Skyra 3.0 T MRI.Positive and negative symptoms scale (PANSS) was used to assess the illness severity of patients with chronic schizophrenia.SPM12 was used to process the collected MRI data. DPARSF was used to calculate the VMHC values of subjects in the two groups. The independent sample t test based on SPM12 was used to compare the VMHC values of the two groups. The significant brain regions in VMHC were regarded as regions of interest (ROI), and VBM8 was used to further analyze the gray matter volume of the ROI of the two groups. Results:Compared with healthy controls, the patients with chronic schizophrenia demonstrated decreased VMHC mainly located in lingual gyrus(voxel=208, T=4.98), occipital middle occipital gyrus(voxel=156, T=3.75) and postcentral gyrus(voxel=237, T=4.36) (FDR correction, q=0.05). Compared with healthy controls, the gray matter volumes in bilateral lingual gyrus(left(0.0034±0.0008), (0.0028±0.0013), t=-2.141, P=0.037; right(0.0025±0.0006), (0.0020±0.0011), t=2.268, P=0.028) and postcentral gyrus((0.0432±0.0051), (0.0372±0.0162), t=-2.070, P=0.045) increased, but non-significant change in postcentral gyrus of the patients with chronic schizophrenia. Conclusion:The abnormal VMHC mainly locate in lingual gyrus, middle occipital gyrus and postcentral gyrus in patients with chronic schizophrenia.

Objective:To understand the iodine content of drinking water and iodine nutrition of key population in Anyang City, Henan Province, and to provide a basis for taking targeted prevention and control measures and scientific adjustment of intervention strategies.Methods:In 2019, stratified sampling method was used to carry out water iodine survey in all townships in Anyang City, and in townships with the median water iodine > 10 μg/L, water iodine survey was carried out in administrative villages, and water iodine content was detected. Two hundred children aged 8 - 10 years and 100 pregnant women were selected from each county (city, district) to test iodine contents of their household salt and urine, respectively.Results:Six hundred and eight water samples were collected in Anyang City, and the median water iodine was 5.98 μg/L. One thousand one hundred and fifty-six samples were collected, and the median water iodine was 34.10 μg/L. A total of 1 605 salt samples were collected in the city, and the median salt iodine was 24.30 mg/kg, the coverage rate of iodized salt was 91.8% (1 473/ 1 605). A total of 1 605 urine samples were collected from children in the city, and the median urinary iodine was 170.10 μg/L. Urine samples of 804 pregnant women were collected, and the median urinary iodine was 190.00 μg/L.Conclusion:Most areas of Anyang City still belong to iodine deficiency area, and the median urinary iodine of children and pregnant women is within the suitable range of iodine.

Objective: To investigate the clinical characteristics of diabetic patients combined with acute myocardial infarction (AMI) and to compare the prognosis between diabetic and non- diabetic patients in 4-5 years after the onset of AMI. Methods: Followed the certain inclusive and exclusive criteria, a total of 420 patients with acute myocardial infarction were included and divided into diabetes group (group D) and non-diabetes group (group N) with numbers as 161 people and 259 respectively. Baseline data, clinical information, short-term outcome and long-term prognosis of the two groups were compared and analyzed. Results: Among the patients with diabetes, the average age was older (65.65±11.33 vs. 63.30±15.34), with fewer males (64.59% vs. 79.92%); and more likely to have other complications as hypertension (64.60% vs. 53.28%) or hyperlipidemia (42.24% vs. 26.25%). 59.29% of the patients in group D showed pathological changes in 3 major coronary arteries, which were significantly more than its counterpart (40.83%). The proportion of patients that had undergone the coronary artery bypass, grafting (11.11% vs. 5.31%) appeared also higher. There was no significant difference seen in the short-term outcomes between the two groups, but results from the long-term follow-up program showed that both the incidence of Major Adverse Cardiovascular Events (MACE) (50.67% vs. 27.72%) and the all-cause mortality (20.00% vs. 9.90%) in group D were higher than those appeared in group N (27.72%). Conclusions Patients suffered from the combination of both diabetes and acute myocardial infarction appeared older in age, more in females, with more complications and the coronary artery lesions were more severe and wider. During hospitalization, no significant difference was seen regarding the short-term outcomes between the two groups but the results from long-term follow-up process showing that the risk of MACE events was significantly higher in patients with type2 diabetes.

Objective: To analyze the expression of c-MET and its prognostic correlation in patients with lung adenocarcinoma. Methods: The clinical data and pathological specimen of patients with lung adenocarcinoma in Dalian 5th People′s Hospital from January 2006 to December 2011 were retrospectively analyzed. The expression difference of c-MET between lung adenocarcinoma tissue and normal adjacent tissues was compared. The correlation of c-MET with the pathology and clinical factors was also analyzed. Results: A total of 82 patients were retrospective analyzed, including 82 pathological specimens of lung adenocarcinoma and 45 specimens of normal adjacent tissues. Among 53 patients with stage Ⅰ-Ⅱ lung adenocarcinoma, 31 cases had low expression of c-MET and 22 cases had high expression of c-MET. Among 29 patients with stage Ⅲ lung adenocarcinoma, 10 cases had low expression of c-MET and 19 cases had high expression of c-MET. There was a correlation between TNM stage and c-MET positive expression in lung adenocarcinoma (P=0.037). The positive expression rate of c-MET was not significantly correlated with age, sex and differentiation degree (P > 0.05). Among 82 cases of lung adenocarcinoma, 39 cases had low expression of c-MET and 43 cases had high expression of c-MET; 45 cases of para-carcinoma tissuehad low expression of c-MET. The positive expression rate of c-MET in lung adenocarcinoma tissues was significantly higher than that in para-carcinoma tissue (P < 0.01). Kaplan-Meier survival curve analysis showed that the median disease-free survival was 41.5 months in c-MET high-expression group and 55.3 months in low-expression group. The expression level of c-MET was closely related to disease-free survival in lung adenocarcinoma patients (P < 0.05). Conclusions The expression of c-MET is significantly increased in patients with lung adenocarcinoma. The expression level has relevance with TNM staging and prognosis.