Objective To evaluate short-term fowllow-up results of castable ceramic-IPS Empress Ⅱ onlays in restoring severe tooth defects with low occlusogingival dimension from clinical aspects.Methods 41 units of the onlay were fabricated and applied in 37 patients,who were divided into experimental group and control group.The experimental group were restored with IPS EmpressⅡcastable ceramic onlay which was bonded by a dual-cure adhesive system.The control group were restored with mental onlay which was bonded by glass-ionomer cements.All these cases were followed at 6 and 12 months after cementation of the restorations.Metewands were established to evaluate its clinical effects.Results Onlay made from IPS Empress Ⅱ castable ceramic demonstrated natural and esthetical appearance.In addition,proximal contact,retention and marginal fit of the restorations were good.No gingivitis was found.Conclusion The reliability of onlay made from IPS Empress Ⅱ castable ceramic is greatly improved due to the strengthening effects of the lithium disilicate structures.In addition,the better esthetics compared to resin filling technique makes it a comparatively ideal all-ceramic system for onlays.

Objective To understand the virology test characteristics of hepatitis B virus (HBV) for discuss the relation of HBV genotype and HBeAg, anti-HBc-IgM, HBV DNA and disease progression. Methods Two hundred cases of hepatitis B were detected by the ELJSA assay with two pairs of semi-markers (HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBc) and anti-HBc-IgM, using fluorescence quantitative polymerase chain reaction (FQ-PCR) for detecting HBV DNA, using monoclonal antibody ELISA method (mAbs ELISA) for HBV genotyping and analysis of test results. Results In 200 patients with hepatitis B, the HBV genotype detected in 179 cases (89.5%), B-type 121 cases(60.5%), C-type 58 cases (29.0% ). There had no relationship with HBeAg, anti-HBc-IgM, HBV DNA and genotype. B-type HBV prevalent in asymptomatic carriers (ASC) and chronic hepatitis B (mild);C-type common in patients with liver cirrhosis (LC) and chronic hepatitis B (severe). Conclusions HBV genotype in Shenzhen mainly is B-type, C-type second;mAbs ELISA assay with HBV genotype is specific, sensitive, simple and practical features, HBV replication strength has nothing to do with the virus genotype. HBV genotype and HBeAg, anti-HBc-IgM, HBV DNA testing may complement each other, with the clinical application value.

Objective To Screen for safe and effective vaccine candidates for EV71,provide a theoretical basis for development of EV71 vaccines in the future.Methods VP1 gene of enterovirus was used to design a target for development of EV71 vaccines.Different vaccine candidates,including inactivated EV71 vaccines,VP1 protein vaccine,DNA vaccines of different doses,were used to challenge female BALB/c mice by intramuscular injection at baseline (0),2 weeks,4 weeks,and caudal vein blood was collected at 0,2,4,6,8,10,and 16 weeks,and BALB/c mice were sacrificed and the spleen cells were collected for detection of both humoral immunity and cellular immunity to evaluate the efficacy and safety of the vaccine candidates.Results IgG antibody titers were increased at 2 weeks,remarkably increased at 4 weeks,reached a peak at 8 weeks,at least sustained for 16 weeks during the whole observation period,subtypes of IgG1 and IgG2a were the major component.The three vaccines could induce cellular immunity characterized by EV71 specific γ-IFN and IL-4 production.Our results indicated that inactivated EV71 vaccine was superior to the other vaccine candidates.Conclusions Inactivated EV71 vaccines,VP1 protein vaccine,DNA vaccines can induce both strong and sustainable humoral and cellular immunities in challenged mice,and the inactivated EV71 vaccine is superior to the other vaccine candidates,which needs to be proved their immunity by challenge assay in the future.

The conventional equilibrium dialysis and ultrafiltration methods cannot be used to determine the protein binding of some peptides because of their non-specific adsorption on the semipermeable membrane or poor stability in the plasma. The method of dextran-coated charcoal adsorption combined with LC-MS/MS were used. Based on the kinetic principle of initial rate of candidate drugs absorbed to dextran-coated charcoal, seven phosphorylated peptides with the same amino acid sequence and different configurations in rat plasma were selected as the study model using; the protein binding in rat plasma were determined; the amino acid distribution rules affecting the changes in protein binding rates of peptide candidate drugs were summarized. The results suggest that the dextran charcoal adsorption method, as a supplementary method for the determination of plasma protein binding, is suitable for peptides or organic drug candidates that cannot be determined by traditional techniques.

Objective To explore the immune response of T helper cells 17 in patients with hepatitis B virus (HBV) and the relation with Th1,Th2 and Treg cells.Methods The percentages of Th17 cells were detected by intracellular cytokine staining with flow cytometry.Using Realtime PCR method,we assayed the mRNA expression of IL-17,T-bet,GATA-3 and FoxP3 in 58 HBV patients and 40 healthy controls in our research.Results Compared with control group (3.56％ ± 1.26％),the percentage of Th17 cells in the peripheral blood of HBV group (4.72％ ± 1.80％) was higher (P ＜0.001).The mRNA of IL-17 expression of the HBV group (4 ±0.49) was higher than in healthy control group (1.19 ±0.19,P ＜ 0.0001).The mRNA of T-bet expression of the HBV group (2.27 ± 0.24) was higher than in healthy control group (1.10 ± 0.13,P ＜ 0.05).The mRNA of GATA-3 expression of the HBV group (2.29 ± 0.16) was higher than in healthy control group (1.10 ± 0.10,P ＜ 0.0001).The mRNA of FoxP3 expression of the HBV group (2.03 ±0.15) was higher than in healthy control group ((1.05 ±0.10,P ＜ 0.0001).Conclusions The Th17 cells participated in immune response of the hepatitis B virus infection patients,and there has certain adjustment relations among Th1,Th2 and Treg cells.

Objective To retrospectively analyze the periprocedural and postprocedural antithrombotic therapy regimens for patients undergoing percutaneous left atrial appendage closure(PLAAC)at Nanjing Drum Tower Hospital(hereinafter referred to as"the hospital")and their association with prognosis,and to provide a basis for antithrombotic therapy in clinical practice for such patients.Methods We systematically collected medical records of non-valvular atrial fibrillation patients underwent PLAAC treatment from January 2018 to January 2022 at our hospital.We recorded basic patient information,preoperative left atrial appendage(LAA)thrombus screening,and antithrombotic regimens,and analyzed the incidence of bleeding and thrombotic events during the periprocedural period and up to 12 months postprocedure.Results A total of 96 patients underwent PLAAC,with 86 included in the final analysis.Eight patients had LAA thrombus detected by transesophageal echocardiography before the procedure,and all thrombi resolved after one month of extended antithrombotic therapy.There was one bleeding event in the continuous anticoagulation group during the periprocedural period,while no bleeding events occurred in the interrupted anticoagulation group.Within one year postprocedure,11 patients(18.0%)in the continuous anticoagulation group and 4 patients(16.0%)in the interrupted anticoagulation group experienced bleeding events.All patients adhered to anticoagulant therapy as prescribed for the first three months postprocedure;between three to six months postprocedure,33.7%of patients received dual antiplatelet therapy(DAPT),and 29.1%discontinued therapy;between six to twelve months,47.7%of patients received single antiplatelet therapy(SAPT)and 48.8%discontinued therapy.During the one-year follow-up,there was one case each of device-related thrombus,ischemic stroke,and cerebral hemorrhage,indicating a low overall incidence of adverse events.Conclusion In the real-world setting,the individualized antithrombotic regimens provided by physicians at the hospital,both periprocedurally and postprocedurally,were reasonable and consistent with guidelines.However,poor medication adherence was a significant issue among patients.It is recommended that clinical pharmacists actively engage in pharmacotherapy monitoring and enhance medication education to improve medication adherence.

Objective:To investigate the serotype features of group B Streptococcus (GBS) vaginal colonization in late pregnancies and their relationship with early-onset neonatal GBS disease (GBS-EOD). Methods:Thirty-two strains were isolated from neonates delivered by GBS-positive mothers and hospitalized for GBS-EOD in Xiamen Maternal and Child Care Hospital from June 2016 to June 2018. Another 266 strains were isolated from vaginal samples from randomly selected late pregnant women who received antenatal screening and delivered in the same hospital during the same period with an allocation ratio of 12∶1. A total of 298 strains from mothers and 32 strains from neonates were involved. Every isolate was serotyped with latex agglutination assay. GBS infection caused by eleven serotypes and the correlation between GBS serotypes in late pregnant women and neonatal GBS-EOD were analyzed. Qualitative variables were compared using Chi-square or Fisher's exact test. A correlation analysis was presented by the column contact number C. Multiple analysis of multiple sample rates was performed with Post hoc testing. Differences between groups were analyzed according to the adjusted standardized residual. Results:A total of nine serotypes were identified among the 298 strains isolated from the mothers. The most prevalent serotype wasⅢ [55.0% (164/298)], followed byⅠb [16.4% (49/298)], Ⅰa [11.1% (33/298)], Ⅴ [9.4% (28/298)], Ⅱ [5.0% (15/298)], non-typable [NT, 1.0% (3/298)], and Ⅵ, Ⅷ and Ⅸ [0.7% (2/298) in each]. Neither Ⅳ nor Ⅶ serotype was identified. The 32 strains isolated from neonates with GBS-EOD belonged to five serotypes, which were Ⅲ [18/32 (56.3%)], Ⅰa [8/32 (25.0%)], Ⅰb [3/32 (9.4%)], Ⅱ [2/32 (6.2%)] and Ⅴ [1/32 (3.1%)]. The positive rates of GBS Ⅲ serotype in neonates with pneumonia, sepsis, and meningitis were 6/13, 7/14, and 5/5. However, no statistically significant difference was observed in the distribution of the five serotypes in GBS-EOD neonates ( P=0.654). Thirty neonates (93.7%) were cured, while two (6.3%) died. There were statistically significant differences among neonatal GBS-EOD caused by vertical transmission with Ⅰa, Ⅰb, Ⅱ, Ⅲ and Ⅴ, Ⅵ, Ⅷ, Ⅸ and NT serotypes ( P=0.046, contingency coefficient: 0.183). Further analysis showed that the adjusted absolute value of the standardized residual of serotype Ⅰa was 2.7 (>2), and the difference was statistically significant. However, the adjusted absolute value of the standardized residual of serotype Ⅲ was only 0.1, which was not statistically significant. Conclusions:Serotype Ⅲ is the most prevalent GBS serotype in late pregnant women and GBS-EOD neonates, and also the predominant serotype in infants with early-onset meningitis. Serotype Ⅰa could be highly vertically transmitted, while the virulence of serotypes Ⅲ and Ⅰa strains of GBS are the strongest.

Cognitive frailty is a state of weakness and mild cognitive impairment in patients without dementia.It directly affects the health of patients with cardiovascular disease, increasing disability risk and reducing quality of life.This article reviews the concept, assessment, epidemiology, prognosis, mechanisms and intervention of cognitive frailty in elderly patients with cardiovascular disease.

Background:Previous studies have proved that neutrophil gelatinase-associated lipocalin(NGAL)plays an important role in the progression of Crohn's disease(CD),and may serve as a potential biomarker for disease activity prediction,severity assessment,treatment response evaluation and prognosis monitoring.However,the diagnostic value of NGAL in perianal fistulizing Crohn's disease(pfCD)is still unclear.Aims:To investigate the serum level of NGAL and its diagnostic value in patients with active pfCD.Methods:A total of 66 patients diagnosed as pfCD from July 2021 to June 2023 at Longhua Hospital,Shanghai University of Traditional Chinese Medicine were enrolled,including 36 active pfCD patients and 30 inactive pfCD patients.The disease activity and perianal fistula activity were assessed by Crohn's disease activity index(CDAI)and perianal disease activity index(PDAI),respectively.Serum NGAL,fecal calprotectin(FC),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),as well as CDAI score and PDAI score were compared between the active and inactive pfCD patients,and the correlations of NGAL with the other parameters in active pfCD patients were analyzed.ROC curve was drawn to evaluate the values of serum NGAL,FC,CRP and ESR for diagnosis of active pfCD.Results:The serum NGAL,FC,CRP,ESR,CDAI score and PDAI score in active pfCD patients were significantly higher than those in inactive pfCD patients(all P＜0.001).NGAL was positively correlated with FC(r=0.64,P＜0.001),CRP(r=0.55,P＜0.001),ESR(r=0.53,P＜0.001),CDAI score(r=0.59,P＜0.001)and PDAI score(r=0.54,P＜0.001)in active pfCD patients.The optimal cut-off values of NGAL,FC,CRP and ESR were 220.5 μg/L,146.0 μg/g,7.9 mg/L and 23.5 mm/h,respectively,for the diagnosis of active pfCD,and the area under the curve were 0.922(95％CI:0.850-0.995),0.888(95％CI:0.806-0.970),0.853(95％CI:0.763-0.944)and 0.830(95％CI:0.731-0.930),respectively.Conclusions:Serum NGAL level is associated with the disease activity of pfCD,and can be used as a non-invasive biomarker for the clinical diagnosis of active pfCD.

At present, the teaching objects of clinical pharmacists have gradually changed from merely university students to complex and diverse groups including clinical pharmacist interns and others. However, the traditional teaching model cannot be tailored to different groups. In addition, it increases the burden of clinical pharmacists while not ensuring teaching quality. This study aims to classify teaching objects according to their characteristics, so as to provide individualized knowledge and service. Compared with the traditional way of teaching, this new method may make teaching more relevant and reduces the teaching load of teachers, which is of great significance to the training of clinical pharmacy personnel.