Bisphosphonate-Associated Osteonecrosis of the Jaw ; Humans

Objective　In a RCT study, the safety and efficacy of sabot (a slow-release salbuteral) and volmax (controlled-release salbuterol) were compared in bronchial asthma. Methods　40 patients with moderate to severe asthma were randomly divided into two groups and treated by sabot or volmax for 2 weeks. The FEV1%, peak expiratory flow (PEF), symptom score and use of rescue ventolin were measured to evaluate the effect of treatment. Results　After treatment FEV1%, PEF and symptom score improved and the need for inhaling short-acting beta 2-agonis in both groups reduced significantly. There was no difference of these improvement between two groups. Conclusion　The safety and efficacy of sabot for treatment of asthma was similar to volmax.

ObjectiveTo observe the prepulse inhibition(PPI) ot the startle reflex of pure cerebral concussion (PCC) suffered from one concussion and multiple cerebral concussion (MCC) suffered from three concussions in rats,and to explore accumulate effect upon cognitive dysfunction of MCC.MethodsA metallic pendulum striker device for closed head injury was employed to duplicate PCC and MCC models in Stragu-Dawley rats.The MCC rats were hit three times on rats'head and it is interval 24 hours for every hit.According to the criteria of cerebral concussion,the investigated animals were divided into PCC group and MCC group at freedom.One control group was used.Each group included 10 animals.Each experience mental animal was tested from 3 days pre-injury to 28 days post-concussion.Startle reflex amplitude (for P values),pre-stimulation induced reflex amplitude on three standard stimulations,that was,67dB,69dB and 73dB (for PP67,PP69 and PP73 values) and prepulse inhibition of the startle reflex (PPI) were collected.ResultsThe P values and three PP values in the first three days of pre-replication experiment,there was no statistical significance in each group.However the P values and PP67,PP69 and PP73 values declined until to the 16th day after injury (P＜0.05),then recovered in PCC group.The P value and PP67,PP69 and PP73 values changes of MCC group declined and not recovered until to test end (P＜0.05 ) and they were more lower than PCC.The three PPI values were a little bit increase in both groups,there were statistics significance at some test points (P＜0.05) compared with control.ConclusionThe startle reflex amplitude and pre-stimulation induced reflex amplitude weaken after cerebral concussion and there is damaging accumulate effect to injury times,the PPI is enlanced by cerebral concussion.

Objective To study the effect of nurse hierarchical management on nurse core competence and responsibility system nursing level.Methods A total of 79 nursing staff in our hospitalwere selected as research objects.Nurses before the implementation of the new nursing management measures (March 2015 to March 2016) were carried out nurse conventional hierarchical management,and those after implementation (April 2016 to April 2017) took new hierarchical management model.The quality of nursing management,the core competency score and the satisfaction of doctors and patients were compared before and after the implementation of new hierarchical management model.Results After implementation,the core competence scores of nursing staff in medical records writing ability and language communication ability were significantly lower than implementation before,the difference was statistically significant (P ＜ 0.05).After the implementation,the nursing management quality in informing precautions after discharge,obligation to inform before operation,and initiative to carry out life care were significantly higher than implementation before (P ＜0.05).Conclusion Nurse level management can improve core competence of nurses,enhance the level of responsibility system and the application effect is more obvious,so it is worthy of promotion.

Objective To study the effect of nurse hierarchical management on nurse core competence and responsibility system nursing level.Methods A total of 79 nursing staff in our hospitalwere selected as research objects.Nurses before the implementation of the new nursing management measures (March 2015 to March 2016) were carried out nurse conventional hierarchical management,and those after implementation (April 2016 to April 2017) took new hierarchical management model.The quality of nursing management,the core competency score and the satisfaction of doctors and patients were compared before and after the implementation of new hierarchical management model.Results After implementation,the core competence scores of nursing staff in medical records writing ability and language communication ability were significantly lower than implementation before,the difference was statistically significant (P ＜ 0.05).After the implementation,the nursing management quality in informing precautions after discharge,obligation to inform before operation,and initiative to carry out life care were significantly higher than implementation before (P ＜0.05).Conclusion Nurse level management can improve core competence of nurses,enhance the level of responsibility system and the application effect is more obvious,so it is worthy of promotion.

Objective To explore the medication rules and mechanism of action of traditional Chinese medicine compound patent formulas for vitiligo,and provide ideas for the development and the patent declaration work of new Chinese medicines for vitiligo.Methods China Patent Publication Bulletin website,National Knowledge Infrastructure Database,Patent Information Service Platform of China Intellectual Property Right Net(CNIPR),and Baiten Patent Platform were used to search for the patents of traditional Chinese medicine compound formulas for vitiligo from the establishment of the databases to 30th September,2023.Excel software and Traditional Chinese Medicine Inheritance Computing Platform(TCMICS V3.0)were used to establish a database of compound formulas,and carry out the statistics of frequency,association rules and clustering analysis of the formulas for internal and external prescriptions.The target and mechanism of action of the internal prescriptions of core high-frequency Traditional Chinese Medicine group for the treatment of vitiligo were further explored by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),Symptom Mapping(Symmap),The Human Gene Database(Genecards),UniversalProtein(UniProt),STRING,Pharmaceutical DataBase(PDB)and other databases as well as software such as R Studio 4.2.2 and Cytoscape 3.9.1,and AutoDock Vina was used for molecular docking validation.Results The internal formulas included 335 patents and the external formulas included 189 patents.The rules of internal and external use are similar.The high-frequency traditional Chinese medicines are Tribuli Fructus,Psoraleae Fructus,Angelicae sinensis,Radix Polygoni Multiflori,Carthami Flos,Angelica dahurica,etc.;the key efficacies of the medicines are based on tonifying the deficiency,activating blood circulation and removing blood stasis;and the properties of the Chinese medicines are the nature of warmth,coldness and flatness,sweetness,bitterness,pungency and attribution to the liver,the spleen,the heart and the kidneys.Commonly used oral medicine pairs are Chuanxiong rhizome-Angelica,Astragalus-Angelica,etc.,high-frequency pairs of external medicines are Fructus mume-Psoraleae fructus,cuscuta-Psoraleae fructus,etc.;internal and external clustering of the core drugs are Psoraleae fructus,Tribuli Fructus,Angelica,Polygonum multiflorum,Angelica dahurica,Safflower,and other high-frequency medicines.The key targets of internal patents for the treatment of vitiligo are genes such as albumin,protein kinase B1,cystatinase 3,etc.The main active ingredients of the internal grouping for the treatment of vitiligo may be quercetin,kaempferol,luteolin,etc.,and the therapeutic mechanism may be related to the end products of glycosylation/receptor for glycosylation end products,tumour necrosis factor signalling pathway,phosphatidylinositol 3-kinase/protein kinase B and other signalling pathways,and involved in the process of blood lipids and atherosclerosis,human cytomegalovirus infection.The molecular docking results confirmed the docking activity of the herbal components with key receptor proteins.Conclusion This study reveals the similarity between the internal and external patented formulas of vitiligo in terms of medication,flavour,and meridian,suggesting that the pathways and indexes such as albumin,interleukin,and tumour necrosis factor of vitiligo patients can be improved by tonifying the liver and kidney,activating blood circulation and removing blood stasis,which also provides a reference for the research and development of new medicines for vitiligo,patent protection,and the use of clinical prescriptions.

Objective To detect the long term effect of pure and multiple concussions on spatial cognitive of rats.Methods One hundred and eighty 7-week-old Spragne-Dawley male rats with weight of 280 ± 30g were chosen and randomly divided into a control group and a concussion group.The cerebral concussion was induced in the rats using a metallic pendulum striker concussive device.After the first strike,the brain injury group was randomly divided into a pure cerebral concussion(PCC)group and a multiple cerebral concussion(MCC) group.After the second strike,the MCC group was randomly divided into two-fold cerebral concussion(2MCC) group and three-fold cerebral concussion(3MCC) group.The striking interval was 24h.One,3 and 6 months after trauma,their cognitive function was tested using Morris water maze.Results One month later after injury,there was no significant difference in the escape latency between the control group and PCC group.Significant differences in the measurement were observed between the control/PCC group and 2MCC group on the 7th day after the injury,also between the control/PCC and 3MCC groups on the 6th and 7th day.And there were significant differences between the 2MCC and 3MCC groups on the 6th and 7th days.The non-platform test did not observe any significant differences among the four groups.Three months after injury,there was still no significant difference between the control group and PCC group,PCC and 2MCC groups,as well as 2MCC and 3MCC groups in the escape latency.However,there was significant difference between the control group and 2MCC group on the 5th,6th and 7th days,between the control group and 3MCC group on the 4th,5th,6th and 7th days,as well as between PCC group and 3MCC group on the 6th and 7th days.In the non-platform test,there was no significant difference between the control group and PCC group,between PCC group and 2MCC group,as well as between 2MCC group and 3MCC group.However,2MCC and 3MCC groups spent significantly less time in the former platform quadrant,when compared with the control group and 3MCC group spent significantly less time than PCC group.Six months after injury,significant differences in the escape latency were observed between the control group and PCC group on the 6th and 7th days,and 2MCC group on the 5th,6th and 7th days,also and 3MCC groups on the 2nd,3rd,4th,5th,6th and 7th days,still between PCC group and 2MCC group on the 6th and 7th days,as well as between PCC group and 3MCC group on the 4th,5th,6th and 7th days.Moreover,there was significant difference between 2MCC and 3MCC groups only on the 7th day.In the non-platform test,PCC group,2MCC group and 3MCC group spent significantly less time in the former platform quadrant compared with the control group.Moreover,in this test significant differences were found between PCC group and 2MCC/3MCC group,but not between 2MCC group and 3MCC group.Conclusion With the increase of cerebral concussion times,earlier and more serious damage of spatial cognition will appear,with a significant cumulative effect in rats.Such rat model can be used to study the pathological changes of cognitive impairment in chronic traumatic encephalopathy.

Objective To observe the changes of the expression of P-glycoprotein(P-gp) after 90 min focal cerebral ischemia reperfusion in rats.Methods The model of.focal cerebral ischemia induced by blocking middle cerebral artery was made by using an intraluminal filament technique.A total of 26 adult SD male rats was used for experiment.One of them was applied for the 2,3,5-triphenyl tetrazolium chloride(TTC) staining to detect whether the focal cerebral ischemia model was successfully made,and the remaining rats were randomly divided into control group(n =5),sham operation group(n =5),and cerebral ischemia reperfusion for 1,3,7 d group(n=5).The immunohistochemistry single staining was used to observe the changes of P-gp in the normal and repefued ischemial brain tissue.The immunofluorescence double staining was used to observe the expression of P-gp in the normal and repefued ischemial brain tissue with Mdr-1 antibody,Neun antibody(marker of the neuron),GFAP antibody(marker of the astrocytes),and CD31 antibody(marker of capillary endothelium).Meanwhile the changes of P-gp in ischemic cerebral cortex and striatum capillary were analyzed by using real-time quantitative PCR technique.Results In control group,P-gp was only located in cerebral microvascular endothelial cells,while in cerebral ischemia reperfusion group,it also could be detected in some neurons and astrocytes.After cerebral ischemia reperfusion,the mRNA expression of P-gp in cerebral cortex was decreased on day 1,significantly increased on day 3,and then decreased on day 7.There was significantly statistical difference of the mRNA expression of P-gp cortex in cerebral ischemia reperfusion for 1,3,7 d group compared with control group and sham group(P＜0.05).After cerebral ischemia reperfusion,the mRNA expression of P-gp in cerebral striatum was increased on day 1,day 3and day 7,especially on day 1 and day 7,and the difference in cerebral ischemia reperfusion group was statistically significant compared with the other two groups (P＜0.05).Conclusion P-gp can only be expressed in cerebral microvascular endothelial cells in normal rats,while it can also be expressed in neurons and astrocytes in rats after the brain's subjection to ischemia reperfusion,and it showed different tendencies between cortex and striatum,which may be regarded as one of the self-protection mechanisms in brain tissue.

Objective:To investigate the changes in structural brain network topology and microstructural damage in patients with multiple sclerosis (MS), and to analyze its correlation with cognitive function.Methods:Clinical and imaging data of 114 patients with MS (MS group) diagnosed in the First Affiliated Hospital of Chongqing Medical University from May 2021 to September 2022 were analyzed retrospectively. In addition, 71 volunteers were recruited as a healthy control group (HC group) during the same period. All subjects were performed on cognitive assessment and 3D-T 1 magnetization-prepared rapid gradient echo, 3D-fluid-attenuated inversion recovery, and diffusion kurtosis imaging (DKI) scans. GRETNA software was used to obtain network topology attributes, and global attributes included global efficiency, local efficiency, and small-world attributes [clustering coefficient(Cp), shortest path length(Lp), normalized Cp(γ), normalized Lp, and small-world index (σ)]. Local attributes included betweenness centrality (BC), degree centrality (DC), nodal clustering coefficient (NCp), nodal efficiency, nodal local efficiency (NLe) and nodal shortest path length. The DKI parameter map generated by the post-processing software was used to extract the DKI parameter values of the brain region with abnormal local topology of the brain structure network. The differences of global attributes, local attributes and DKI parameter values [kurtosis fractional anisotropy (KFA), mean kurtosis (MK), radial kurtosis (RK) and axial kurtosis (AK) values] were analyzed by independent sample t-test or Mann-Whitney U test, and corrected by false discovery rate (FDR). Spearman or Pearson correlation analysis was used to evaluate the correlation between abnormal brain structure network topology attributes and cognitive scale scores in the MS group. Results:Both the MS group and the HC group structure network showed small-world attributes, and the γ and σ values of the MS group were significantly lower than those in the HC group (FDR correction, P<0.05). Compared with the HC group, BC, DC, NCp and NLe broadly reduced in the MS group, mainly involving in bilateral frontal, temporal, precuneus, amygdala, and thalamus (FDR correction, P<0.05). After FDR correction, compared with the HC group, the KFA, MK, RK and AK values of 23 brain regions with abnormal local attributes of the network in the MS group were significantly changed in several brain regions (FDR correction, P<0.05). The correlation analysis showed, after FDR correction, the DC value of the right putamen in MS patients was positively correlated with the digit span test (DST) scores ( r=0.318 ,P=0.001). Conclusion:There are extensive changes in the structural brain network of MS patients, accompanied by varying degrees of microstructural damage, and the reduction of degree centrality in the basal ganglia putamen region is associated with cognitive impairment.

Objective:To investigate the distribution of iron deposition in the substantia nigral (SN) subregions on quantitative susceptibility mapping (QSM) and the change of swallow tail sign (STS) in patients with relapsing-remitting multiple sclerosis (RRMS) of different disease stages.Methods:The clinical and imaging data of 53 patients with RRMS (case group) diagnosed at the First Hospital of Chongqing Medical University from November 2019 to December 2021 were retrospectively analyzed. The case group was divided into 0-5 years subgroup, 6-10 years subgroup, and >10 years subgroup according to the disease duration; another 37 age-and gender-matched healthy volunteers were recruited as the control group during the same period. All subjects underwent MRI and QSM reconstruction. First, the SN was divided into four subregions: rostral anterior-SN (aSNr), rostral posterior-SN (pSNr), caudal anterior-SN (aSNc), and caudal posterior-SN (pSNc) on the QSM, and the quantitative susceptibility value (QSV) of each subregion was measured, and then the STS of the SN was observed and scored on the susceptibility weighted imaging (SWI) generated by post-processing. ANOVA was used to compare the differences in the QSV of each subregion of SN among the groups, and the probability of abnormal STS was compared using the χ 2 test. Spearman′s test was used to analyze the correlation between the QSV of each subregion of SN and the STS score. Results:The differences in QSV of aSNr, pSNr, aSNc, and pSNc were statistically significant among the 0-5 years subgroup, 6-10 years subgroup,>10 years subgroup of RRMS patients and the control group ( P<0.05). The QSV of aSNr, pSNr, and aSNc in 0-5 years subgroup was higher than those in the control group ( P was 0.039, 0.008, 0.039, respectively). The QSV of aSNr, aSNc, and pSNc in the 6-10 years subgroup were higher than those in the 0-5 years subgroup ( P was <0.001, 0.020, 0.015, respectively). The QSV of the aSNc, pSNc in >10 years subgroup were lower than those in the 6-10 years subgroup ( P=0.037, 0.006). The QSV of aSNr, pSNr in >10 years subgroup were higher than those in the control group ( P was <0.001, 0.001). There were 7 cases of abnormal STS in the 0-5 years subgroup, 11 cases in the 6-10 years subgroup, 12 cases in >10 years subgroup, and 9 cases in the control subgroup, and there was a statistically significant difference in the probability of abnormal STS among the subgroups of the RRMS patients and the control subgroup (χ 2=16.20, P=0.011). Both the scores of STS in the 6-10 years subgroup and >10 years group were positively correlated with the QSV in pSNc ( r s=0.65, P=0.006; r s=0.48, P=0.045). Conclusions:In RRMS patients, SN iron deposition is concentrated on aSNr, pSNr, and aSNc in the 0-5 years subgroup and on aSNr, aSNc and pSNc in the 6-10 years subgroup. The QSVs of all SN subregions have a downward trend in >10 years subgroup compared with that in the 6-10 years subgroup. Both the QSVs of the pSNc in the 6-10 years group and >10 years group are positively related to STS scores. These help explore the potential progression pattern of SN iron deposition in RRMS patients and the cause of abnormal STS in RRMS patients.