Objective: To investigate treatment strategies for chronic periapical periodontitis in prematurely erupted premolars and provide guidance for managing pulp and periapical diseases in young permanent teeth with immature roots. Methods: A regenerative endodontic procedure (REP) was performed on a prematurely erupted maxillary left first premolar (tooth 24) at Nolla stage Ⅶ with chronic apical periodontitis, following standardized protocols including root canal irrigation, disinfection, and coronal sealing. The case was followed up, and a literature review was conducted. Results: Clinical resolution of symptoms was observed on tooth 24, with sustained root development. After a 20-month follow-up, the tooth had restored biological function. Literature synthesis revealed that periapical infections in prematurely erupted permanent teeth predominently arise from pulp exposure and bacterial infection, with retrograde infection being rare. For young permanent teeth with necrotic pulp, regenerative endodontic procedures has been established as the treatment of choice to promote apical closure and root maturation. The critical steps of regenerative endodontic procedures include thorough disinfection, induced bleeding to form a fibrin scaffold, and coronal sealing to facilitate stem cell recruitment and differentiation. Conclusion Regenerative endodontic procedures represents an effective and viable treatment option for prematurely erupted young permanent teeth with chronic periapical periodontitis.

Objective To investigate the impact of COVID-19 infection on the early clinical outcomes of patients undergoing valve replacement. Methods Perioperative data of patients who underwent single valve replacement at the Second Affiliated Hospital of Chinese People&#39;s Liberation Army Medical University from January to February 2023 were consecutively collected. Based on COVID-19 infection status, patients were divided into a COVID-19 group and a non-COVID-19 group. The perioperative data were compared between the two groups. Results A total of 136 patients were included, comprising 53 males and 83 females, with a mean age of (53.4±10.2) years. There were 32 patients receiving aortic valve replacements, 102 mitral valve replacements, and 2 tricuspid valve replacements. The COVID-19 group comprised 70 patients, and the non-COVID-19 group included 66 patients. No statistical difference was observed in the incidence of postoperative complications between the two groups [9.09% (6/66) vs. 11.43% (8/70), P=0.654]. However, the COVID-19 group had longer postoperative mechanical ventilation duration [1 201.00 (1 003.75, 1 347.75) min vs. 913.50 (465.50, 1 251.00) min, P=0.001] and ICU stay [3 (2, 3) days vs. 2 (2, 3) days, P<0.001] compared to the non-COVID-19 group. Additionally, troponin I [4.76 (2.55, 7.93) ng/mL vs. 2.66 (1.19, 5.65) ng/mL, P=0.001] and brain natriuretic peptide [608.50 (249.75, 1 150.00) pg/mL vs. 192.00 (100.93, 314.75) pg/mL, P<0.001] levels were significantly higher in the COVID-19 group. Conclusion For patients with single valve disease undergoing elective surgery, short-term outcomes after recovery from COVID-19 infection are favorable, with no significant increase in in-hospital mortality or postoperative complication rates.

AIM:To provide a clinical reference for the design of personalized surgical parameters for cataract, swept source optic coherence tomography angiography(SS-OCTA)was applied to comparatively study the blood flow of the macular area before operation in patients with different intraocular pressure during cataract surgery.METHODS: Prospective randomized controlled study. A total of 61 patients(77 eyes)who underwent cataract surgery in Sichuan Provincial People&#39;s Hospital from January to April 2021 were collected and divided into group A(37 eyes)and group B(40 eyes)for the study using a random number table. Group A and group B received the height of 75 and 90cm perfusion bottles with intraoperative,corresponding to 55.5 and 66.6mmHg intraoperative mean intraocular pressure,respectively. All patients were examined with SS-OCTA in macula area before and 1,7 and 30d after surgery, except routine ophthalmologic examination, the macular retinal thickness, the perfusion area and vessel density of the radial perioptic capillary plexus(RPCP)layer, superficial vascular plexus(SVP)layer, intermediate vascular plexus(IVP)layer and deep vascular plexus(DVP)layer were observed.RESULTS: There were no significant differences in the best corrected visual acuity(BCVA), intraocular pressure, foveal avascular zone(FAZ), macular retinal thickness, perfusion area and vascular density between the two groups at each time point before and after surgery(all P>0.05),but there were differences in time(all P<0.05). In both groups, BCVA improved significantly from preoperative values at all time points after surgery, intraocular pressure and FAZ decreased compared with preoperative values(all P<0.05), and macular retinal thickness, perfusion area in all layers, and blood flow density were increased compared with preoperative values.CONCLUSION:The macular retinal thickness, blood flow density and perfusion area of all layers increased,and the FAZ area decreased after cataract surgery, which may help to promote the recovery of visual acuity after surgery. At different intraocular pressures of 55.5 and 66.6mmHg intraoperatively, there was no significant difference in the patients&#39;postoperative fundus blood flow changes, therefore, intraocular pressure can be flexibly selected during the operation to provide patients with personalized surgical design.

Objective To investigate the relationship between gait spatiotemporal parameters and balance function in stroke hemiplegic patients. Methods From September, 2018 to March, 2020, 76 stroke hemiplegic patients (38 in Brunnstrom Ⅳ and V, respectively) were assessed balance function with Active Balancer EAB-100 and Star Excursion Balance Test (SEBT), and gait parameters of speed, cadence and asymmetry, named step length asymmetry ratio (SLA), swing time asymmetry ratio (SWTA), stance time asymmetry ratio (STA), maximum flexion angle ratio (MFA) of hip and knee. The correlation among gait parameters and balance function was analysed. Results The balance and gait parameters were better in those in Brunnstrom V than in Brunnstrom Ⅳ (|t| > 2.268, P < 0.05). The speed and cadence correlated with the most balance indexes (|r| > 0.335, P < 0.05). SLA correlated with SEBT in Brunnstrom Ⅳ patients (r = -0.467~-0.613, P < 0.01), while it correlated with medial-lateral (M-L) stability limits in Brunnstrom V patients (r = -0.356, P = 0.028). SWTA correlated with stability limit of Anterior-Posterior (A-P) (r = -0.335, P = 0.040) and M-L (r = 0.510, P = 0.001), and most of SEBT (r = -0.330~ -0.445, P < 0.05) in Brunnstrom Ⅳ patients. MFA of hip and knee correlated with balance indexes in Brunnstrom Ⅳ patients (|r| > 0.326, P < 0.05), while MFA of knee correlated with most balance indexes in Brunnstrom V patients (r > 0.329, P < 0.05), and MFA of hip correlated with A-P stability limit (r = 0.369, P = 0.023). Conclusion Both speed and cadence of steps can well respond to the balance function in stroke hemiplegic patients. For the asymmetry, it is related with balance in patients with poorer recovery.

Objective To analyze the status of hepatitis B and BCG vaccination in children with special health status, and analyze the reasons for the delay of vaccination, so as to improve the timely vaccination rate. Methods A total of 1 129 children with special health status who were registered and vaccinated in our hospital from September 1, 2018 to January 23, 2020 were selected. All children were classified according to the major diseases based on the discharge records. The first injection time of hepatitis B and BCG vaccine was extracted, and the children were divided into different groups based on the number of people who delayed vaccination. The comparison between groups was performed by χ² test. Results A total of 87 children without hepatitis B vaccination and 85 children without BCG vaccination were immediately vaccinated in our hospital after the establishment of the archives in our hospital. None of the 1 129 children with special health status had serious adverse reactions after vaccination. The most common diseases in the delayed hepatitis B vaccination children were premature infants, cardiovascular diseases, and nervous system diseases. The most common diseases in the delayed BCG vaccination children were premature infants, cardiovascular diseases, and neonatal disease. There was a significant difference between the number of delayed hepatitis B vaccination and the number of delayed BCG vaccination, with the number of delayed BCG vaccination being more (χ²=278.24, P<0.00). Conclusion Delayed vaccinations are common in children with special health status. Normal vaccination does not increase the incidence of adverse reactions in children with special health status. Medical staff’s understanding of diseases, types of diseases, and types of vaccines are important factors affecting the vaccination of children with special health conditions. Support from social environment, the understanding and cooperation from children's parents and guardians, and the understanding of medical workers on vaccines and diseases are the keys to truly improve the vaccination rate of children..

AIM: To analyze the role of preoperative telephone interview in the cancellation rate for ophthalmic daytime surgery.

METHODS: A prospective, single center study was conducted to compare and analyze the cancellation of daytime surgery in two time periods. The control group was from June 2018 to June 2019, only routine nursing and health education were implemented. The patient in the intervention group were from October 2019 to October 2020, add the telephone interview of the day before operation was added by the nurses in the ophthalmic operating room.

RESULTS: The main reasons for canceling the operation included upper respiratory tract infection, abnormal blood glucose, abnormal blood pressure and physiological period, abnormal preoperative examination results, and patients didn&#39;t follow the doctor&#39;s advice to use preoperative eye drops. In the control group, there were 16 974 cases scheduled for daytime operation, 16 332 cases actually operated, and the cancellation rate of operation was 3.78%(642 cases cancelled). In the intervention group, 17 694 cases were scheduled for daytime operation, and 17 296 cases were actually operated, with the cancellation rate of 2.25%(398 cases cancelled). The disease distribution and cancellation reasons of the two groups were statistically significant(P<0.05).

CONCLUSION: Telephone interview can effectively reduce the cancellation rate of ophthalmic daytime operation, provide targeted and personalized pre-hospital guidance for patients, improve the compliance of patients and their families to complete preoperative preparation, reduce the psychological anxiety of patients before operation, and improve the medical experience of patients.

[摘 要] 目的：设计并制备一种分别靶向B细胞表面抗原CD19和CD22的CAR-T细胞，检测其对肿瘤细胞的体内外杀伤效果。方法：将含有人源化 CD19 ScFv的二代CAR分子和带有CD3ε链作为共刺激结构域的CD22 ScFv CAR分子以P2A自剪切肽连接，序列连接于慢病毒载体pLTR-CMV-MCS中，以HEK-293T细胞包装相应的慢病毒载体，感染健康志愿者提供的T细胞制备CAR-19-22-T细胞，同时以相同二代结构分别构建单靶向CAR-T细胞作为参照。构建表达荧光素酶、CD19和/或CD22的前列腺癌3M细胞（靶细胞）。将各种CAR-T细胞与靶细胞共同培养，采用荧光素酶化学发光法和ELISA法检测其对靶细胞的杀伤能力和细胞因子的分泌水平。通过尾静脉注射Raji-Luc细胞构建NOD-SCID免疫缺陷小鼠白血病模型，分别注射各组CAR-T细胞进行治疗并评估其疗效。结果：培养7 d的CAR-19-22-T细胞的CAR-19表达率为13.7%，CAR-22表达率为14.3%。CAR-19-22-T细胞在10∶1效靶比时，对3M-CD19-Luc、3M-CD22-Luc和3M-CD19-CD22-Luc细胞的杀伤率均显著高于T细胞[（78.1±14.4）% vs （11.1±4.3）%、（46.7±10.7）% vs （12.4±2.7）%、（90.5±4.3）% vs （14.3±3.7）%，均P<0.01]；与3M-CD19-Luc、3M-CD22-Luc、3M-CD19-CD22-Luc靶细胞共培养后，CAR-19-22-T细胞IFN-γ、TNF-α和IL-2水平均显著低于CAR-19-T和CAR-22-T细胞（P<0.05或P<0.01）。CAR-19-22-T细胞对移植Raji-Luc细胞模型小鼠治疗效果明显，其生存期显著长于T细胞组（P<0.01），与CAR-19-T组和CAR-22-T组荷瘤小鼠比较差异均无统计学意义（均P>0.05）。结论：成功设计并制备了一种双靶点CAR-19-22-T细胞，其能够有效杀伤表达CD19和/或CD22抗原的肿瘤细胞，对Raji-Luc细胞的白血病模型小鼠有显著的治疗效果。

Objective: To explore the protective effects of anthrahydroquinone-2,6-disulfonate (AH 2 QDS) on the kidneys of paraquat (PQ) poisoned rats via the apelin-APJ pathway. Methods: Male Sprague Dawley rats were divided into four experimental groups: control, PQ, PQ+sivelestat, and PQ+AH 2 QDS. The PQ+sivelestat group served as the positive control group. The model of poisoning was established via intragastric treatment with a 20% PQ pesticide solution at 200 mg/kg. Two hours after poisoning, the PQ+sivelestat group was treated with sivelestat, while the PQ+AH 2 QDS group was given AH 2 QDS. Six rats were selected from each group on the first, third, and seventh days after poisoning and dissected after anesthesia. The PQ content of the kidneys was measured using the sodium disulfite method. Hematoxylin-eosin staining of renal tissues was performed to detect pathological changes. Apelin expression in the renal tissues was detected using immunofluorescence. Western blotting was used to detect the expression levels of the following proteins in the kidney tissues: IL-6, TNF-α, apelin-APJ (the apelin-Angiotensin receptor), NF-κB p65, caspase-1, caspase-8, glucose-regulated protein 78 (GRP78), and the C/EBP homologous protein (CHOP). In in vitro study, a PQ toxicity model was established using human tubular epithelial cells treated with standard PQ. Twenty-four hours after poisoning, sivelestat and AH 2 QDS were administered. The levels of oxidative stress in human renal tubular epithelial cells were assessed using a reactive oxygen species fluorescence probe. Results: The PQ content in the kidney tissues of the PQ group was higher than that of the PQ+AH 2 QDS group. Hematoxylin-eosin staining showed extensive hemorrhage and congestion in the renal parenchyma of the PQ group. Vacuolar degeneration of the renal tubule epithelial cells, deposition of crescent-like red staining material in renal follicles, infiltration by a few inflammatory cells, and a small number of cast formation were also observed. However, these pathological changes were less severe in the PQ+sivelestat group and the PQ+AH 2 QDS group (P<0.05). On the third day after poisoning, immunofluorescence assay showed that the level of apelin in the renal tissues was significantly higher in the PQ+AH 2 QDS group than in the PQ group. Western blotting analysis results showed that IL-6, TNF-α, NF-κB p65, caspase-1, caspase-8, GRP78, and CHOP protein levels in the PQ group were higher than in the PQ+AH 2 QDS group (P<0.05). The expression of apelin-APJ proteins in the PQ+AH 2 QDS group was higher than in the PQ+sivelestat and PQ groups (P<0.05); this difference was significant on Day 3 and Day 7. The level of oxidative stress in the renal tubular epithelial cells of the PQ+AH 2 QDS group and the PQ+sivelestat group was significantly lower than in the PQ group (P<0.05). Conclusions: This study confirms that AH 2 QDS has a protective effect on PQ-poisoned kidneys and its positive effect is superior to that of sivelestat. The mechanism of the protective effects of AH 2 QDS may be linked to reduction in cellular oxidative stress, PQ content of renal tissue, inflammatory injury, endoplasmic reticulum stress, and apoptosis. AH 2 QDS may play a role in the treatment of PQ poisoning by upregulating the expression of the apelin-APJ.

Objective To analyze the screening results and risk assessment of common malignant tumors among female residents in Deyang from 2017 to 2019, so as to provide basis for cancer prevention and control. Methods Women who underwent physical examinations and completed the survey of common malignant tumors related risk factors from 2017 to 2019 were selected. The high risk rate, screening rate and detection rate of common malignant tumor among female urban residents in Deyang were analyzed. Results From 2017 to 2019, a total of 49,871 female urban residents completed the survey of common malignant tumor related risk factors. The risk rates of breast cancer, lung cancer, cervical cancer and colorectal cancer were 13.24%, 7.65%, 12.92% and 5.53%, respectively. Among all the age groups, women at the age of 50~59 years old were at the highest risk of breast cancer, lung cancer, cervical cancer, colorectal cancer; The screening rates of breast cancer, lung cancer, cervical cancer and colorectal cancer were 24.68%, 11.72%, 34.62% and 14.15%, respectively; The screening rates of breast cancer, lung cancer, cervical cancer and colorectal cancer among women with different educational levels showed significant difference (P<0.05). The screen rates of breast cancer, lung cancer, cervical cancer and colorectal cancer among high risk groups were 24.68%, 11.75%, 26.56% and 14.35%, respectively; The detection rates of breast cancer, lung cancer, cervical cancer and colorectal cancer among the screening groups were 9.33%, 2.68%, 9.82%, and 2.02%, respectively (P<0.05). Conclusion Female residents in Deyang from 2017 to 2019 have high risk and detection rates of breast cancer and cervical cancer, so active screening of malignant tumors among urban female residents can effectively improve the residents&#39; quality of life, and is of vital importance for the early diagnosis and treatment of malignant tumors.

Objective To study the brain cell injuries and behavioral changes of newborn rats with kernicterus. Methods Twenty-five 5-day-old Sprague-Dawley rats were divided into control group (n=11) and model group (n=14) radomly. The model group was injected with bilirubin solution 10 μg/g in the cisterna magna, while the control group was injected with equal volume of normal saline. The neurobehavioral changes were observed and the body mass were recorded. TUNEL staining was used to check the apoptosis of striatal nerve cells of basal ganglia in the model group (n=3) on the first day after modeling. The remaining rats were assessed by gait analysis and beam-walking test 19 days after birth, and Morris water maze test was performed 30 days after birth. Results The model group showed apparently abnormal neurobehavioral changes, such as clenched fists, opisthotonos and the body mass were significantly lower in the model group than in the control group (F>27.707, P<0.001). TUNEL staining showed striatal nerve cells apoptosis in the model group. For the gait analysis, the step lengths of both hind legs were shorter (t>4.129, P<0.01), and the difference of step length was longer (t=-4.415, P<0.001) in the model group than in the control group, however, there was no significantly difference in the step width between two groups (t=0.462, P=0.649). For the beam-walking test, the score was lower in the model group than in the control group (t=-3.644, P=0.004). For the Morris water maze test, the escape latency was longer (F>6.206, P<0.05), and the number of crossing platform was less (t=3.297, P=0.004) in the model group than in the control group. Conclusion The newborn rats&#39; model of kernicterus showed deficits in multiple motor functions and learning and memory ability, which could be assessed by gait analysis, beam-walk test and Morris water maze test, respectively.