Objective To analyze the application effect of glass fiber pile and cast metal pile in tooth defect repair and its influence on periodontal tissue.Methods From February 2014 to February 2015,112 patients with dental defect in the Central Hospital of Yiwu were randomly divided into the control group and the research group according to the digital table,with 56 cases in each group.The control group received the casting metal pile repair,the research group was repaired with glass fiber piles.The remediation effect,periodontal tissue status,inflammatory response and adverse reaction were compared between the two groups.Results The success rate of the research group was significantly higher than that of the control group(89.29％vs.66.07％),and there was statistically significant difference(χ2 =8.70,P<0.05).After treatment,the alkaline phosphatase,interleukin-6(IL-6)and interleukin-8(IL-8)levels of the two groups were increased compared with before treatment,which of the research group were obviously lower than those of the control group [(440.75 ±55.75)U/L vs.(491.75 ±62.59)U/L,(18.77 ± 2.21)ng/L vs.(30.65 ±3.97)ng/L,(51.42 ±6.32)μg/L vs.(76.33 ±9.50)μg/L],there were statistically significant differences(t=4.52,19.56,16.33,all P<0.05).After treatment,the periodontal examination depth of the two groups was(2.15 ±0.29)mm and(2.17 ±0.25)mm,respectively,and there was no statistically significant difference(t=0.39,P>0.05).Conclusion The effect of glass fiber pile in tooth defect repair is better than cast metal pile,and its stability and biocompatibility are better,and it is a simple operation,which is worthy of clinical promotion.

By integrating the concept of narrative medicine and relevant models and tools into the Doctor-patient Communication course， this paper expounds the connotation of narrative medicine under the context of “new medicine” and “big health” and the practical significance of the shift to narrative in Doctor-patient Communication course in three aspects： academic frontier， social needs and practical needs. This paper analyzes the four dimensions of innovation that narrative medicine， as the frontier of the discipline， historical accumulation， educational philosophy and professional skills， provides for the Doctor-patient Communication course， and explores the effective path to realize the narrative transformation of the course. It is expected to achieve the purpose of forging students’ humanistic medical skills and literacy through teaching innovation， realizing the coordination of medical education and competency orientation， adapting to the psychological and social increase， the change of people and health， and promoting the reform of the supply side of medical talents.

Traditional antibody drug conjugates(ADC)combine monoclonal antibodies with cytotoxic drugs to accurately strike cancer cells,but there are still many shortcomings in stability,targeting,efficacy,and safety.Novel ADC,such as bi-specific,site-specific,dual-payload,and pro-drug type ADC,can be optimized by simultaneously binding 2 different antigens or epitopes,selecting more stable linkers,coupling with specific amino acid sites of antibodies,carrying different drug payloads,and adopting prodrug strategies,while retaining the characteristics of traditional ADC.Significantly improving the stability,targeting,efficacy and safety of drugs can better meet the needs of clinical treatment.Novel ADC will play a more important role in cancer treatment in the future.Discussing the progress of novel ADC in cancer treatment and analyzing their advantages and challenges can provide theoretical support for the development of anti-cancer strategies and provide directions for drug research and development.

Although immunotherapy has made a breakthrough in the treatment of cancer,the emergence of drug resistance has limited be-nefits in most patients,and reversing immunotherapy resistance remains a hotly debated and unresolved issue.The tumor microenviron-ment(TME)comprises a large number of T lymphocytes.During the biological processes of proliferation,activation,and the effect of tumor-infiltrating lymphocytes(TILs),TILs face severe local metabolic stress,resulting in metabolic reprogramming to meet the markedly increased energy demand and biosynthesis requirements.This process of adaptive changes in the metabolic pattern is closely related to the pheno-type and function of TILs,affecting immunotherapy efficacy and mediating immunotherapy resistance.In recent years,with the study of TIL metabolism and the search for specific metabolic regulatory points,targeting the TIL metabolic pathway could restore the tumor-killing func-tion and reverse immunotherapy resistance.This review explores the relationship between the metabolic reprogramming of TILs and im-mune resistance,and provides a new strategy for reversing immune resistance.