Objective　To explore independent risk factors for early neurological deterioration in first-ever minor ischemic stroke without reperfusion therapy,and to achieve individualized prediction by constructing a nomogram model.Methods　We enrolled first-ever minor ischemic stroke patients of non-reperfusion therapy from January 1,2017 to December 31,2019 in the Zhaoqing First People’s Hospital.The clinical and imaging data of the Neurological deterioration group(END group) and the non-END group were analyzed.The independent related factors were screened and the nomogram model was constructed.Results　A total of 384 cases were enrolled,including 66 cases (17.19%) in the END group and 318 cases (82.81%) in the non-END group.Logistic regression analysis showed that diabetes mellitus,TOAST typing,albumin levels,and cerebral atherosclerosis score (CAS) were independent influencing factors (P<0.05).The nomogram model is constructed and the ROC curve is generated,and the area under the curve is 0.859［95%CI(0.758,0.864)］.Model consistency can be hinted at by the calibration curve and the Hoster-Lemeshow test.Finally,the clinical decision curve indicates that the model has clinical application value.Conclusion　This study explores the nomogram model for END in first-ever minor ischemic stroke without reperfusion therapy,which has some clinical application value,is composed of four major factors:diabetes mellitus,TOAST typing,albumin level and CAS.

Periodontium regeneration and repair is a controversial and difficult point in the treatment of periodontosis. The proliferation, differentiation, migration and adhesion of periodontal ligament cells and the dynamic relationship between periodontal ligament cells and their extracellular matrix proteins are the basis of periodontium morphological reconstruction, functional maintenance and tissue repair. This article reviews the mechanism of estrogen-regulated periodontal membrane fine repair and periodontal tissue reconstruction to provide the basis for follow-up research on the treatment of periodontitis and the promotion of periodontal tissue repair and reconstruction by exogenous estrogen-mediated periodontal membranes. Under the regulation of certain concentrations of estrogen, the proliferation and differentiation ability of periodontal ligament stem cells (PDLSCs) and bone mesenchymal stem cells (BMSCs) to other periodontal ligament cells were enhanced. At the same time, PDLSCs, BMSCs, human periodontal ligament fibroblasts (HPLFSs), osteoblasts and cementoblasts synthesized and secreted collagen I (COLI), osteopontin (OPN), bone sialoprotein (BSP) and osteocalcin (OCN) into the extracellular matrix. They interact with fibronectin (FN) and cementum attachment protein (CAP) in the extracellular matrix to form a variety of chain complexes and regulate each other, thus promoting the growth, migration, adhesion and fibrosis of periodontal ligament cells, repairing the collagen fiber skeleton of the periodontal ligament and adhering the two ends to the new cementum and the inherent alveolar bone.

Objective:To investigate the prognosis of patients with initially resectable gastric cancer liver metastasis (GCLM) who were treated by different modalities, and analyze the influencing factors for prognosis of patients.Methods:The retrospective cohort study was conducted. The clinicopathological data of 327 patients with initially resectable GCLM who were included in the database of a nationwide multicenter retrospective cohort study on GCLM based on real-world data from January 2010 to December 2019 were collected. There were 267 males and 60 females, aged 61(54,68)years. According to the specific situations of patients, treatment modalities included radical surgery combined with systemic treatment, palliative surgery combined with systemic treatment, and systemic treatment alone. Observation indicators: (1) clinical characteristics of patients who were treated by different modalities; (2) prognostic outcomes of patients who were treated by different modalities; (3) analysis of influencing factors for prognosis of patients with initially resectable GCLM; (4) screening of potential beneficiaries in patients who were treated by radical surgery plus systemic treatment and patients who were treated by palliative surgery plus systemic treatment. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. The Kaplan-Meier method was used to calculate survival rate and draw survival curve, and Log-Rank test was used for survival analysis. Univariate and multivariate analyses were conducted using the COX proportional hazard regression model. The propensity score matching was employed by the 1:1 nearest neighbor matching method with a caliper value of 0.1. The forest plots were utilized to evaluate potential benefits of diverse surgical combined with systemic treatments within the population. Results:(1) Clinical characteristics of patients who were treated by different modalities. Of 327 patients, there were 118 cases undergoing radical surgery plus systemic treatment, 164 cases undergoing palliative surgery plus systemic treatment, and 45 cases undergoing systemic treatment alone. There were significant differences in smoking, drinking, site of primary gastric tumor, diameter of primary gastric tumor, site of liver metastasis, and metastatic interval among the three groups of patients ( P<0.05). (2) Prognostic outcomes of patients who were treated by different modalities. The median overall survival time of the 327 pati-ents was 19.9 months (95% confidence interval as 14.9-24.9 months), with 1-, 3-year overall survival rate of 61.3%, 32.7%, respectively. The 1-year overall survival rates of patients undergoing radical surgery plus systemic treatment, palliative surgery plus systemic treatment and systemic treatment alone were 68.3%, 63.1%, 30.6%, and the 3-year overall survival rates were 41.1%, 29.9%, 11.9%, showing a significant difference in overall survival rate among the three groups of patients ( χ2=19.46, P<0.05). Results of further analysis showed that there was a significant difference in overall survival rate between patients undergoing radical surgery plus systemic treatment and patients undergoing systemic treatment alone ( hazard ratio=0.40, 95% confidence interval as 0.26-0.61, P<0.05), between patients undergoing palliative surgery plus systemic treatment and patients under-going systemic treatment alone ( hazard ratio=0.47, 95% confidence interval as 0.32-0.71, P<0.05). (3) Analysis of influencing factors for prognosis of patients with initially resectable GCLM. Results of multivariate analysis showed that the larger primary gastric tumor, poorly differentiated tumor, larger liver metastasis, multiple hepatic metastases were independent risk factors for prognosis of patients with initially resectable GCLM ( hazard ratio=1.20, 1.70, 1.20, 2.06, 95% confidence interval as 1.14-1.27, 1.25-2.31, 1.04-1.42, 1.45-2.92, P<0.05) and immunotherapy or targeted therapy, the treatment modality of radical or palliative surgery plus systemic therapy were independent protective factors for prognosis of patients with initially resectable GCLM ( hazard ratio=0.60, 0.39, 0.46, 95% confidence interval as 0.42-0.87, 0.25-0.60, 0.30-0.70, P<0.05). (4) Screening of potentinal beneficiaries in patients who were treated by radical surgery plus systemic treatment and patients who were treated by palliative surgery plus systemic treatment. Results of forest plots analysis showed that for patients with high-moderate differentiated GCLM and patients with liver metastasis located in the left liver, the overall survival rate of patients undergoing radical surgery plus systemic treatment was better than patients undergoing palliative surgery plus systemic treatment ( hazard ratio=0.21, 0.42, 95% confidence interval as 0.09-0.48, 0.23-0.78, P<0.05). Conclusions:Compared to systemic therapy alone, both radical and palliative surgery plus systemic therapy can improve the pro-gnosis of patients with initially resectable GCLM. The larger primary gastric tumor, poorly differen-tiated tumor, larger liver metastasis, multiple hepatic metastases are independent risk factors for prognosis of patients with initial resectable GCLM and immunotherapy or targeted therapy, the treatment modality of radical or palliative surgery plus systemic therapy are independent protective factors for prognosis of patients with initially resectable GCLM.

Objective: To explore the potential mechanism of pimecrolimus in airway remodeling of atopic dermatitis (AD) and asthma mice. Methods: Female BALB/c mice were randomly divided into three groups: control group, atopic dermatitis group and pimecrolimus treatment group. The cell in bronchoalveolar lavage fluid (BALF) was calculated by Ray-Jimsa staining. The structural changes in lung tissue and skin tissue were observed by hematoxylin-eosin (HE) staining, and the level of interleukin (IL)-33, IL-5, IL-13 in serum was detected by enzyme-linked immunosorbent assay (ELISA). The expressions of type 1 collagen (Col1) in the airway of mice were detected by RT-PCR and Western blotting. And western blotting was also used to determine the activation of mitogen-activated protein kinase P38 (P38MAPK) and mitogen-and stress-activated protein kinase 1 (MSK1) in the lungs of mice. Results: Compared with those in the control group, the total number of leukocytes in bronchoalveolar lavage fluid (BALF) and the expression levels of IL-33, IL-13 and IL-5 in serum of atopic dermatitis group were significantly higher, and the difference was statistically significant (P < 0.05). In the atopic dermatitis group, the phosphorylation of P38MAPK and MSK1 protein was increased (1.50 ± 0.43 vs. 0.80 ± 0.43, 1.39 ± 0.08 vs. 0.62 ± 0.08) and the expression of Col1 protein and protein (1 vs. 3.20 ± 0.59, 1.40 ± 0.12 vs. 0.13 ± 0.16) was increased, and the difference was statistically significant (P < 0.05). After pimecrolimus treatment, the number of leukocytes in BALF, the levels of IL-33, IL-5 and IL-13 in serum (213.13 ± 11.89, 657.97 ± 86.47, 143.82 ± 33.02), the phosphorylation of P38MAPK and MSK1 protein in lung tissue (0.10 ± 0.04, 0.85 ± 0.05), and the expression of Col1 mRNA and Col1 protein were decreased (0.61 ± 0.22, 0.48 ± 0.08), and the difference was statistically significant (P < 0.05). The edema of lung and skin tissue and the infiltration of inflammatory cells were alleviated. Conclusions Pimecrolimus can alleviate the inflammation and airway remodeling in mice by inhibiting the activation of IL-33 related pathways, thereby reducing the incidence of asthma.

OBJECTIVESince 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve.

METHODA nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system.

STATISTICAL ANALYSISthe growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1.

RESULTA total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method.

CONCLUSIONUsing GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.

Birth Weight ; China ; Female ; Gestational Age ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Male