Objective To observe and identify the impact of a type of macro?pore bone block bioactive glass on osteo?blast in vitro. Methods Extract fluid of new bioactive glass was prepared withα?MEM culture medium as the bioactive medium group. And the concentrations of different ions were detected with Inductively Coupled Plasma?Atomic Emission Spectrometry in bioactive medium group andα?MEM medium group. MC3T3?E1 cells cultured in bioactive medium group were considered as ex?perimental group and cells cultured inα?MEM medium as control group. Giemsa and immunofluorescence staining was performed to detect the cell numbers, the karyoplasmic ratio and the average fluorescence intensity per cell. Cell proliferation and viability in different groups were detected by cell cycle analysis, MTT assay and BrdU assay, respectively. Total RNAs of cells in different groups were extracted and the expressions of ALP, OCN and collagenⅠwere measured by quantitative real time PCR. ALP stain?ing and alizarin red staining were performed to assess the differentiation and mineralization of MC3TC?E1 cells in different groups. Results The concentrations of Si and F were 40.02 ± 0.67 mg/L and 0.02 ± 0.001 mg/L in bioactive medium group, higher than 2.02±0.01 mg/L and 0.00 mg/L inα?MEM solution, and the concentration of Ca was lower than that inα?MEM solution. The con?centration of P and Na had no difference. In Giemsa staining, the cell number in 400 times field under a microscope was 106.0 ± 6.025 in bioactive medium group and 40.20 ± 3.639 inα?MEM medium group. In the immunofluorescence of vinculin, the karyo?plasmic ratio and the expression of vinculin were higher in bioactive medium group (40.85±5.720, 0.050 88±0.021 78) than inα? MEM medium group (21.93 ± 4.137, 0.023 60 ± 0.003 18). In cell cycle analysis, the proportion of cells retained in S and G2/M phase in the bioactive medium group was more than that in theα?MEM medium group after 72 hours of cell culture. In the BrdU and MTT assay, MC3T3?E1 cells in bioactive medium group both showed a higher proliferation rate with statistical significance. In MC3T3?E1 cells cultured with the bioactive medium, the expressions of osteogenesis?related genes were higher than those cultured with ordinaryα?MEM solution;in the ALP staining and alizarin red staining, the expression of ALP and the mineralization rate were higher in bioactive medium group (1.328%±0.015 36%, 2.953%±0.536 3%) than inα?MEM medium group (0.979%±0.030 59%, 1.000%±0.208 1%). Conclusion The bioactive medium promotes cell proliferation and osteoblastic differentiation of MC3T3?E1 cells, and has much more Si ions, which indicates that macro?pore bone block bioactive glass can promote cell proliferation and dif?ferentiation and has promising bioactivity.

Objective To explore the polarization and proliferation of naive CD4+TT cells after preincubation with interleukin-2. Methods The expression of suppressor of cytokine signal (SOCS)-3 was detected by the real-time PCR in the naive T lymphocytes of DO11.10 TCR transgenic and C57BL/6N mice after they were preincubated by 50 U/ml of IL-2. The naive CD4+T T lymphocytes preincubated for 4 h by IL-2 were stimulated with ovalbumin (OVA) and inactivated BALB/c spleen cells, respectively. After 14 d, IL-12Rβ1, IL-12β2 and cytoplasm IL-4 (cyIL-4) were detected by flow cytometry. Results SOCS-3 in the naive CD4+T lymphocytes of DO11. 10 TCR transgenic and C57BL/6N mice reached the peak after preincu- bated by IL-2 for 6 h. The polarization to TH1 and the proliferation ability of naive CD4+ T lymphocytes stimulated with specific antigen and allogeneic antigen were inhibited conspicuously during the time of the peak of SOCS-3. Conclusion The expression of SOCS-3 in naive CD4+T lymphocytes can be upregulated by IL-2. The upregulation of SOCS-3 can suppress the polarization to TH1and the proliferation ability of naive CD4+T lymphocytes stimulated by specific antigen and allogeneic antigen.

Objective:To investigate the mechanism of subjective cognitive decline(SCD)in resting-state by using regional homogeneity(ReHo)and functional connectivity(FC)in SCD patients.Methods:Resting-state functional magnetic resonance imaging(RS-fMRI)was performed in 25 SCD patients and 30 normal controls matched by sex, education and nationality.DPARSFA2.3 and SPM8 software were used to analyze and screen the brain areas with abnormal ReHo values in SCD group, with the posterior cingulated(PCC)/paruneus as seed points for whole-brain FC analysis.Results:Compared with the normal control group, the SCD group showed that ReHo values of right occipital gyrus and left precuneus were increased, and ReHo values of right inferior temporal gyrus, right orbital inferior frontal gyrus and bilateral thalamus were decreased(Voxel level, Alphasim correction, P<0.05). Using PCC/ precuneus as seed voxels, the whole brain functional connectivity analysis showed that the functional connectivity with cerebelum Crus 2 R was increased, and the functional connectivity with right orbital inferior frontal gyrus, left inferior temporal gyrus and temporal pole was reduced(Voxel level, Alphasim correction, all P<0.05). Conclusions:Default mode network may play an important role in the mechanism of SCD, and abnormalities in brain areas may first occur in PCC/precuneus.

Objective:To investigate regional homogeneity(ReHo)and whole brain functional connectivity(FC)in patients with mild cognitive impairment(MCI), and to explore the mechanisms of MCI in the resting state.Methods:Resting-state functional magnetic resonance imaging(RS-fMRI)was performed on 24 patients with MCI and 30 age, gender and nationality-matched normal controls.Abnormal brain areas in the MCI group were screened and analyzed by using the DPARSFA2.3 and SPM8 software programs.Whole brain FC analysis was performed with the posterior cingulate cortex(PCC)/precuneus as the seed points.Results:Compared with the control group, MCI subjects displayed higher ReHo values in the frontal-middle-Left, precentral-Left, postcentral-Left, rolandic-opercular-Left, and frontal-inferior-opercular-Left and lower ReHo values in the temporal-superior-right, temporal-middle-right, postcentral-right, and temporal -pole -superior -right(Voxel level, Alphasim correction, P<0.05). Whole brain FC analysis showed greater functional connectivity of PCC/precuneus with fusiform-right, thalamus-right, lingual-right and parahippocampal-right in subjects with MCI, and less functional connectivity of the PCC/precuneus with temporal-middle-Left, angular-Left, temporal-superior-Left and occipital-middle-Left in subjects with MCI(Voxel level, Alphasim correction, P<0.05). Conclusions:Abnormalities of the default mode network may be associated with the onset of MCI, and abnormalities in posterior cingulate/precuneus connectivity may be helpful in finding imaging evidence with high sensitivity to MCI.

Objective:To investigate the value of 3D printing combined with intraoperative electrophysiological monitoring in excision of cerebellopontine angle (CPA) tumor.Methods:The clinical data of 43 patients with CPA tumor, admitted to our hospital from October 2016 to October 2019, were collected and analyzed. These patients were voluntarily divided into ordinary group ( n=27) and optimized group ( n=16). Patients in the ordinary group were operated microscopically, and those in the optimized group were operated microscopically with 3D printing combined with intraoperative electrophysiological monitoring. The degrees of tumor resection and neurological functions (facial and auditory nerve function, swallowing function, limb activity) improvements were compared between the two groups. Results:The degrees of tumor resection of the optimized group were significantly higher than those of the ordinary group ( P<0.05), and the improvement of facial and auditory nerve function in the optimized group was significantly better than that in the ordinary group ( P<0.05). There was no significant difference in improvements of swallowing function and limb activity between the two groups ( P>0.05). Conclusion:The 3D printing combined with intraoperative electrophysiological monitoring can improve the resection rate of CPA tumor, protect the facial auditory nerve, and improve the quality of life of patients after surgery.

Objective: To verify the criteria validity and effectiveness of the QCSS-E for screening of mild cognitive impairment (MCI) and early dementia with Alzheimer's type (DAT) among the elderly in community. Methods: With stratified convenient sampling, 1 298 elderly aged 55 and over recruited from Wuxi community, who finished the clinical interviews, laboratory examination and psychological tests such as QCSS-E, ADL, MMSE, ADAS-cog, CDR, and Core Neuropsychological Test.Then they were divided into health control group(HC), MCI group and DAT group by the diagnostic criteria of Peterson’s MCI and DSM-5 AD dementia.The criteria validity and screening efficacy of QCSS-E were verified and the optimal cut off value for detecting MCI and DAT were explored. Results: There were statistically significant differences in age, education level, marital status, family structure, occupation, and scores of MMSE, ADAS-cog, CNT, and QCSS-E total score and domain scores among three groups (all P<0.01). The total score and every domains score of QCSS-E were significantly correlated with test scores such as MMSE, ADAS-cog and CNT (all P<0.01). Using the total QCSS-E score to discriminate MCI from health control, the area under the curve (AUC) was 83.5%. When the cut off value was 74.5, the accuracy rate of classification was the highest (75.0%). Using the total QCSS-E score to discriminate DAT from health control, the AUC was 83.5%. When the cut off value was 64.5, the accuracy rate of classification was the highest (94.2%). Conclusion The QCSS-E has better criteria validity and higher effectiveness in screening MCI and DAT.

ObjectiveTo investigate the association between spontaneous portosystemic shunt （SPSS） and hepatorenal syndrome （HRS） in patients with liver cirrhosis. MethodsA retrospective analysis was performed for 93 patients with SPSS from Dezhou Hospital， Qilu Hospital of Shandong University， from January 2015 to January 2022， and the patients were followed up for 12 months with the onset of HRS as the observation endpoint. According to the presence or absence of HRS， the 93 patients with SPSS were divided into HRS group with 38 patients （40.86%） and non-HRS group with 55 patients （59.14%）， and the two groups were compared in terms of clinical data， laboratory data， complication， and shunt diameter. Based on the maximum shunt vein diameter of 1.5 cm， the 93 patients with SPSS were divided into high shunt group with 52 patients （55.91%） and low shunt group with 41 patients （44.09%）， and with the onset of HRS as the observation endpoint， the two groups were compared in terms of the incidence rate of HRS and survival time curve. The independent-samples t test was used for comparison of normally distributed continuous data with homogeneity of variance between two groups， and the chi-square test was used for comparison of categorical data between two groups. The receiver operating characteristic （ROC） curve was used to predict cut-off values， the Kaplan-Meier curve was used for comparison of survival time， and the Log-rank test was used to compare the differences in survival curves. The multivariate Cox regression analysis was used to investigate risk factors. ResultsCompared with the non-HRS group， the HRS group had significant increases in Child-Pugh score， Child-Pugh class， MELD score， serum creatinine， blood urea nitrogen， alanine aminotransferase， aspartate aminotransferase， maximum shunt vein diameter， the incidence rates of hepatic encephalopathy and spontaneous bacterial peritonitis， and the degree of ascites， as well as significant reductions in main portal vein diameter， serum sodium and albumin （all P<0.05）. Compared with the low shunt group， the high shunt group had a significant increase in the incidence rate of HRS （51.92% vs 26.83%， χ²=5.974， P=0.015） and a significant reduction in the time to the onset of HRS （Log-rank P=0.033）. A maximum shunt vein diameter of >1.5 cm （hazard ratio ［HR］=1.123， 95% confidence interval ［CI］： 1.041‍ ‍—‍ ‍1.211， P=0.003）， an increase in MELD score （HR=1.205， 95%CI： 1.076‍ ‍—‍ ‍1.437， P=0.039）， a reduction in serum albumin （HR=0.890， 95%CI： 0.814‍ ‍—‍ ‍0.974， P=0.011）， an increase in the degree of ascites （HR=2.099， 95%CI： 1.066‍ ‍—‍ ‍4.130， P=0.032）， and spontaneous bacterial peritonitis （HR=2.259， 95%CI： 1.020‍ ‍—‍ ‍5.003， P=0.045） were independent risk factors for the onset of HRS in SPSS patients. ConclusionThere is an association between SPSS and HRS， and shunt diameter >1.5 cm was an independent risk factor for HRS in SPSS patients， which should be taken seriously and require early intervention in clinical practice.

ObjectiveTo understand the infection characteristics of multidrug-resistant organisms (MDROs) in hospitalized patients in a tertiary sentinel hospital in Shanghai, so as to provide an evidence for the development of targeted prevention and control measures. MethodsData of MDROs strains and corresponding medical records of some hospitalized patients in a hospital in Shanghai from 2021 to 2023 were collected, together with an analysis of the basic information, clinical treatment, underlying diseases and sources of sample collection. ResultsA total of 134 strains of MDROs isolated from hospitalized patients in this hospital were collected from 2021 to 2023 , including 63 strains of methicillin-resistant Staphylococcus aureus (MRSA), 57 strains of carbapenem-resistant Acinetobacter baumannii (CRAB), and 14 strains of carbapenem-resistant Klebsiella pneumoniae (CRKP). Of the 134 strains, 30 strains were found in 2021, 47 strains in 2022 and 57 strains in 2023. The male-to-female ratio of patients was 2.05∶1, with the highest percentage (70.90%) in the age group of 60‒<90 years. The primary diagnosis was mainly respiratory disease, with lung and respiratory tract as the cheif infection sites. There was no statistically significant difference in the distribution of strains between different genders and infection sites (P>0.05). However, the differences in the distribution of strains between different ages and primary diagnosis were statistically significant (P<0.05). Patients who were admitted to the intensive care unit (ICU), had urinary tract intubation, were not artery or vein intubated, were not on a ventilator, were not using immunosuppresants or hormones, and were not applying radiotherapy or chemotherapy were in the majority. There was no statistically significant difference in the distribution of strains for whether received radiotherapy or chemotherapy or not (P>0.05), while the differences in the distribution of strains with ICU admission history, urinary tract intubation, artery or vein intubation, ventilator use, and immunosuppresants or hormones use or not were statistically significant (all P<0.05). The type of specimen was mainly sputum, the hospitalized ward was mainly comprehensive ICU, the sampling time was mainly in the first quarter throughout the year, the number of underlying diseases was mainly between 1 to 2 kinds, the application of antibiotics ≥4 kinds, and those who didn’t receive any surgery recently accounted for the most. There were statistically significant differences in the distribution of strains between different specimen types, wards occupied and history of ICU stay (P<0.05), but no statistically significant difference in the distribution of strains between different sampling times, number of underlying diseases and types of antibiotics applied (P>0.05). ConclusionThe situation of prevention and control on MDROs in this hospital is still serious. Focus should be placed on high-risk factors’ and infection monitoring and preventive measures should be strengthened to reduce the incidence rate of MDROs infection.