Objective To evaluate salivary gland function in primary Sjgren′s syndrome (pSS) objectively,and highly sensitive and significant indicators were chosen by correlative analyses of parameters of salivary gland scintigraphy with the histopathologic grading of labial biopsy in pSS.Methods Salivary gland scintigraphy was preformed using 99m TcO - 4 in 78 patients with pSS and 20 normal controls.Functional parameters of the parotid (Par) glands were calculated.The results of pSS groups were compared with normal controls.All patients with pSS underwent labial biopsy after imaging and Spearman rank correlation test was used for scintigraphy functional parameters and histopathologic grading.Results ① The maximum accumulation ratio (MAR) of Par gland significantly decreased with histopathologic grading increase ( r = -0 649, P

Objective To discuss the clinical significance of serum pyridinoline cross-linked carboxy-terminal telopeptide of typeⅠcollagen in patients with rheumatoid arthritis (RA). Methods Serum ⅠCTP was measured by ELISA and RF, CRP by immunonephelometry assay in 55 patients with active and 25 with stable RA as well as 52 age and sex-matched normal controls. Results SerumⅠCTP was positively correlated with RF and CRP (rs=0.407, 0.534, P0.05). The sensitivity, specificity and accuracy of serumⅠCTP test were 67.3%, 84.6%, 75.7% in serum of the patients with active RA respectively. The mean serumⅠCTP in normal controls was (3.5?2.0) ?g/L. The serumⅠCTP was more sensitive than CRP in the patients with active RA. Conclusion SerumⅠCTP in patients of RA is a reliable assistant marker for early diagnosis, monitoring of the course and the effectiveness of treatment.

Objective:To investigate the role of TcpC in uropathogenic Escherichia coli (UPEC)-induced cystitis in mice and to preliminarily analyze the pathogenic mechanism. Methods:C57BL/6 mice were injected with 10 9 CFU wild-type UPEC CFT073 (CFT073 wt) or tcpc gene-deleted mutant (CFT073 Δ tcpc) from urethra into bladder to construct the mouse model of cystitis. The mice were sacrificed 3 d after infection and the bladders were taken to observe the gross pathological changes. Histopathological changes in bladder tissues were observed after HE staining. Immunohistochemistry was used to detect TcpC in bladder tissues. Bacterial loads in urine samples of UPEC-infected mice were counted by tenfold dilution method, and the presence of tcpc gene in the genomic DNA of bacteria from the bladder and urine samples of CFT073 wt-infected mice was measured by PCR. Real-time quantitative RT-PCR (qRT-PCR) and Western blot were performed to detect the expression of TcpC at mRNA and protein levels in macrophages after CFT073 wt infection. The influence of UPEC strains on the activation of NF-κB signaling pathway in macrophages were determined by Western blot. The levels of proinflammatory factors and the bacterial and cell activity after infecting macrophages with UPEC strains were detected by ELISA, laser confocal microscope and fluorescence microscope, respectively. Results:Compared with the mice with CFT073 Δ tcpc infection, CFT073 wt-infected mice had significantly enlarged bladder and severe neutrophil infiltration and abundant TcpC in bladder tissues. The number of bacteria in the urine of CFT073 wt-infected mice was significantly greater than that of the CFT073 Δ tcpc group. PCR results showed that the bacteria in bladder or urine were CFT073 wt. The expression of TcpC at both mRNA and protein levels in macrophages increased significantly after CFT073 wt infection. Moreover, in CFT073 wt-infected macrophages, the expression of IκBα was promoted and the phosphorylation of p65 and the production of proinflammatory factors were suppressed. TcpC was instrumental in the survival and invasion of CFT073 wt in macrophages. Conclusions:TcpC expression increased significantly in mice with CFT073 wt-induced cystitis. TcpC inhibited the activation of NF-κB signaling pathway and the production of proinflammatory factors in macrophages to improve the survival rate of CFT073 wt, which was closely related to the pathogenesis and immune evasion of UPEC.

The standardized residency training has become a necessary way to improve the overall professional quality of doctors. At present, a single teaching model can't meet the needs of the standardized residency training. This study explores the application of problem-based learning (PBL) combined with multidisciplinary treatment (MDT) model in the general surgery teaching of standardized residency training, so that the residents can use their theoretical knowledge to think deeply about the problems in the cases. By consulting the literature review, the cases are analyzed from multiple levels and angles, such as pathogenic causes, pathogenesis and clinical manifestations, then the clinic diagnosis and therapeutic schedule can be obtained. This kind of teaching model not only stimulates the group's more interest in learning, and improves the ability of autonomous learning, independent analysis, problem solving and language expression, but also significantly improves teaching satisfaction and has obvious teaching advantages.

Objective To investigate the experience of intrauterine device(IUD)removal in patients with cervical cancer after radiotherapy.Methods A total of 23 patients with cervical cancer after radiotherapy underwent abdominal ultrasound guided hysteroscopic removal of IUD in our department from January 2020 to December 2022.For vaginal and/or cervical adhesions,blunt separation of adhesions was performed by using hysteroscope head or curved forceps under abdominal ultrasound guidance.If it was difficult to separate the adhesions for hysteroscope head entering the uterine cavity,a probe was inserted into the uterine cavity under ultrasound guidance,and the cervical canal was gradually expanded to 6-caliber dilation rod.Then the hysteroscope was inserted again into the uterine cavity.For obvious cervical atrophy that was tough in which cervical forceps could not be used to clamp the cervix,a 1-0 absorbable suture line was used to suture the anterior and/or posterior lips of the atrophied cervix at the top of the vagina,with an assistant firmly pulling and fixing the cervix.Results There were 4 cases of vaginal partial adhesions and cervical contracture,10 cases of cervical contracture,and remaining 9 cases having no vaginal adhesions and cervical contracture.Under hysteroscopy,there were 3 cases of cervical adhesions,2 cases of endometrial polyps,1 case of submucosal uterine fibroids,2 cases of uterine abscess,2 cases of incarcerated IUD,and remaining 13 cases having normal uterine cavity morphology.All the 23 cases of IUD were successfully removed by using abdominal ultrasound guided hysteroscopy(circular shaped in 12 cases,uterine shaped in 6 cases,V-shaped in 2 cases,Y-shaped in 1 case,T-shaped in 1 case,and umbrella shaped in 1 case).The surgical time was(19.2±10.9)min,and there were no complications such as false passage formation,uterine perforation,organ damage,massive vaginal bleeding,transurethral resection of the prostate syndrome,infection,embolism,or shock.The 23 cases were followed up for 2-24 months postoperatively,with a median of 12 months.One case continued concurrent radiotherapy and chemotherapy,3 cases continued post-loading radiotherapy,1 case continued chemotherapy,and 2 cases received targeted treatment(distant metastasis).The remaining 16 cases recovered well in regular reviews without complications such as abdominal pain,fever,or vaginal bleeding.Conclusions If the size and location of the cancer lesion do not affect the removal of IUD after radiotherapy for cervical cancer,it should be removed as soon as possible.The application of abdominal ultrasound guided hysteroscopy in IUD removal in patients with cervical cancer after radiotherapy is safe and feasible to a certain extent.

Objective:To evaluate the severe occlusal surface wear of implant-supported full-arch prostheses, and to explore the risk factors affecting the severe occlusal surface wear of implant-supported full-arch prostheses.Methods:Five hundred and thirty-five patients who received implant-supported fixed complete dental prostheses or implant-overdentures and completed at least one follow-up 3 months after the delivery of definitive prostheses were enrolled from October 1994 to October 2021 in this retrospective cohort study. The information on demographics, implants, definitive prostheses, and related outcomes was collected. Cox proportional hazard regression model was adopted to analyze the risk factors of the severe wear of occlusal surfaces in implant-supported full-arch prostheses. Univariate analysis was performed on the factors that may affect the severe wear of occlusal surfaces, and the parameters of P<0.10 in univariate analysis were included in multivariate analysis to explore the risk factors affecting the severe wear of occlusal surfaces in implant-supported full-arch prostheses. Results:Severe wear of the posterior occlusal surfaces was detected in 114 prostheses with a duration of 61.4 (33.3, 89.4) months. 13 cases occurred ≤2 years after the delivery of definitive prostheses, 44 cases>2 years and ≤5 years, 44 cases>5 years and ≤10 years, and the other 13 cases>10 years. There was no significant difference in the average time of severe occlusal surface wear between implant-supported fixed complete dental prostheses and implant-overdentures in the maxilla ( Z=-1.03, P=0.303). However, in the mandible, it was 48.2 (31.2, 80.2) and 79.2 (51.3, 119.1) months respectively, which was statistically significant ( Z=-2.93, P=0.003). Cox proportional hazard regression model showed opposed fixed dentition, bruxism, and posterior resin occlusal surfaces were risk factors ( P<0.05) affecting the severe wear of the occlusal surfaces. Conclusions:Severe occlusal surface wear was clinically common with the prolonged application of implant-supported full-arch prostheses. Prostheses opposed to fixed dentition, in patients with bruxism, and made of posterior resin materials were at higher risk of severe occlusal surface wear on the posterior artificial teeth. Regular follow-up, patients′ behavior guidance, and clinicians′ appropriate intervention were necessary to manage this complication.