Incidence of thrombotic disease is very high, and this disease can result in high mortality and high disability rate. Prevention and treatment of the disease mainly include:antiplatelet, anticoagulation and thrombolysis. Choice of anti?thrombotic treatment based emphasizes on individuation. As a direct inhibitor of factor Xa, Rivaroxaban exert its anticoagu?lant activity without antithrombinⅢbut is ineffective to theⅩa in prothrombin complex, which can be used as a substitute of traditional anticoagulant. In this paper, applications of Rivaroxaban on treating symptomatic venous thromboembolic dis?ease, postoperative venous thrombosis and cardiovascular thrombosis are reviewed.

Objective To assess the diagnostic value of the latent membrane protein 1(LMP-1)gene detection for diagnosing na-sopharyngeal carcinoma(NPC).Methods The related researches on the detection of LMP-1 gene in the nasopharyngeal swab secre-tion for diagnosing NPC by PCR were entirely collected by using the computer retrieval or manual inquiring.Two estimators screened the literature according to the criteria of inclusion and exclusion.The quality evaluation was performed by adopting the QUADAS scale.The heterogeneity test was conducted by using Meta-Disc 1.4 software.According to the heterogeneous character-istics,the corresponding effect model was selected for calculating the pooled sensitivity and specificity and the summary receiver op-erating character(SROC)curve was drawn.Results 139 related articles were retrieved,in which 6 articles were finally included. 394 cases of NPC were definitely diagnosed by the pathological golden standard,802 cases were in the control group.The pooled sensitivity and specificity of the LMP-1 gene for diagnosing NPC were 0.90[95%CI (0.87,0.93)]and 0.98[95%CI (0.96,0.99)] respectively.The area under SROC(AUC)was 0.973 7.Conclusion LMP-1 gene has the higher diagnostic value for NPC and could be used for screening and auxiliary diagnosis of NPC.

Objective To study the clinical effects of the combination of the topping tongue method and the scraping tongue method in speech training after the operation of ankyloglossia with lingua apical articulation disor-der.Methods Based on the random control study design,50 cases of ankyloglossia with lingua apical articulation disorders were randomly allocated into experimental group (25 cases)and control group (25cases).Patients of ex-perimental group were given routine speech training with the topping tongue and scraping tongue methods.Patients of control group were given routine speech training,and data of voice intelligibility of two groups of patients were collected at the time before speech training and after 3 courses of speech training.Results The voice intelligibility of two groups of patients before speech training had no statistically significant differences(t =0.726,P >0.05 ).But the voice intelligibility of the patients after 3 courses of speech training in both groups was obviously improved. There were statistically significant differences(P <0.001).Patients in the experimental group had a higher voice in-telligibility score assessed after 3 courses of speech training than the control group.After treatment,the voice intel-ligibility of the patients in experimental group increased from 37.91% to 87.69%.The voice intelligibility of the pa-tients in the control group increased from 37.69% to 72.99%.There were statistically significant differences(P <0.001).Conclusion The combination of the topping tongue and scraping tongue methods can improve the speech intelligi-bility for patients after operation of ankyloglossia and promote rehabilitation training of the lingua- apical articulation.

Objective To study the phonological characteristics and rehabilitation training methods of abnor-mal blade-alveolar consonants in children with functional articulation disorders(FAD).Methods A total of 150 children of 4 to 25 years old with blade-alveolar consonant articulation disorders were selected from 194 children di-agnosed with FAD as the research objects.The phonological characteristics of abnormal blade-alveolar consonants were analysed;30 children of 4 to 17 years old accepted speech therapy,exhaling training and functional treatment of blade-alveolar consonants (/d/,/t/,/n/,/l/).Patients were given speech assessments in the first and last training by using computer speech lab.Results The occurrence rate of abnormal blade-alveolar consonant was 77.32%(150/194);the error rate of/l/was 82.0% which was the highest;/d/was mainly substituted by/j/,and/t/was mainly substituted by/q/,/d/.Both/l/and/n/mainly showed omission.Males accounted for 82.35%(98/119) and females accounted for 80.65%(25/31)among substitution cases.Males accounted for 80.67%(96/119)and fe-males for 90.32%(28/31)among omission cases.The number of incorrect words decreased to (6.30±2.72)after speech training from(50.60±9.04)before speech training was established.The differences were statistically signifi-cant(Z= -4.875,P<0.05).The number of erroneous words was negatively correlated with age (r= -0.736,P<0.01).Conclusion Blade-alveolar consonant articulation disorders occur mainly on/d/,/t/,/l/,and the main erro-neous articulation patterns are substitution and omission.The training scheme and training methods established in this study are significantly effective.

Objective To explore the age effects on the prognosis of patients with dysarthria after lingual fre-nectomy ,to provide clinical basis for the corresponding speech evaluation and treatment of the patients .Methods 154 patients with dysarthria one month after lingual frenectomy were recruited as the research objects ,83 cases of preschool ,52 cases of school-age ,adolescent 11 cases and 8 cases of adult were included .Their articulation was re-corded after postoperative recovery one month by the computer speech lab (Model 4500) according to the test table , then the recording materials were analyzed .After the patients' phonetic intelligibility(PI) was evaluated ,the corre-lation and simple linear regression analysis for age and PI were carried on .Results The PI of patients with dysar-thria one month after lingual frenectomy was positively correlated with age (r=0 .467 ,P<0 .05) .That indicates PI has an increasing trend with the growth of age .The result of simple linear regression analysis showed that the deter-mination coefficient of age to PI was 0 .270 .It showed that age had an influence on the prognosis of patients with PI after lingual frenectomy .Conclusion Aging was one of the important factors for the prognosis of patients with dys-arthria after lingual frenectomy ,but it is not the only factor .The patients with dysarthria one month after lingual fre-nectomy should be received treatment in time ,speech training must be corrected at about 4 to 8 years old with dysarthriawithout surgery .

Background Package and tissue patch implantation are common methods for repair of filtering bleb leaking after anti-glaucoma surgery.But the scarring or re-leakage of filtering bleb probably occur again.Objective This study was to investigate the repair effect of acellular dermal matrix (ADM) on filtering bleb leaking in rabbit model and compare the effectiveness among ADM,amniotic membrane and conjunctival overlap.Methods Trabeculectomy was performed on 48 eyes of 24 New Zealand rabbits,and models of filtering bleb leaking were established.The models were randomized into ADM group,amniotic membrane group and conjunctival covering group based on randomized number table.ADM patches with 4 mm×4 mm were implanted across lamellar cornea and sclera at a bridge in the ADM group,and the same size of amniotic membranes were used in the amniotic membrane group,and conjunctiva was sutured to limbus in the conjunctiva overlap group.The intraocular pressure (IOP) was measured before surgery and 1 day,1 week,1 month,3 months and 6 months after surgery.The biocompatibility of materials above was assessed under the slit lamp microscope,and the status of filtering bleb was evaluated and compared with anterior segment optical coherent tomography (AS-OCT) 1 day,1 week,1 month,3 months and 6 months after surgery.Results Before surgery and 1 day,1 week,1 month,3 months and 6 months after surgery,the IOP was (26.9±4.3),(16.6±5.1),(22.1 ±6.2),(18.3±6.5),(22.7±2.5),(23.4±1.4) mmHg in the AMD group,(29.9±5.4),(14.9 ± 6.4),(21.6 ± 7.8),(26.3 ± 4.1),(26.0 ± 4.2) and (23.0 ± 5.3) mmHg in the amniotic membrane group,and (28.7 ±4.3),(15.7 ±7.0),(22.0±6.3),(28.2±4.1),(24.7 ±4.1),(23.0±2.7) mmHg in the conjunctival overlap group,showing significant differences among different groups and various time points (Fgroup =8.419,P=0.011 ;Ftme =15.543,P=0.000).The IOPs were significantly lower from 1 day through 3 months after operation than those before operation in the AMD group (P =0.000,0.000,0.006,0.045) ; while the IOPs were reduced only from 1 day through 1 week after operation in comparison with before operation in the amniotic membrane group and the conjunctival overlap group (P =0.000,0.001).One month after surgery,the IOPs were significantly declined in the ADM group compared with the amniotic membrane group and the conjunctival overlap group (P =0.001,0.000).The grafts were clear under the slit lamp microscope and exhibited the valid filtering bleb until 3 months after operation under the AS-OCT in the ADM group.However,the valid filtering bleb remained only 1 month after surgery in the amniotic membrane group and the conjunctival overlap group.Neovascularization on the filtering bleb was found 3 months in the AMD group but 1 month in the amniotic membrane group and the conjunctival overlap group.Conclusions Compared with amniotic membrane and conjunctival tissue,ADM patch for the repair of filtering bleb leakage can increase the survival duration of filtering bleb and remain lower IOP.

Objective To explore the clinical characteristics of lateral misarticulation. Methods 39 patients with lateral misarticulation were recruited. Their articulation was recorded by the computer speech lab according to the Putonghua syllable chart of the collocation of consonants and vowels, then the recording materials were analyzed. Results 22 cases with lateral misarticulation were on both sides, 14 cases were on the right side and 3 cases on the left side. Lateral misarticulation mainly occurred in consonants with the highest incidence in /z/, / c/, /s/, /zh/, /ch/, /sh/, /j/, /q/ and /x/. There were two or more release bursts in the spectrogram of lateral misarticulation. There was no significant correlation between the number of lateral misarticulation and age (r=0.110, P=0.507). Conclusion Lateral misarticulation mainly occurs in supradental, blade-palatal and lingua-palatal phoneme. The time-domain waveform diagram and spectrogram are helpful for the diagnosis of lateral misarticulation. Lateral misarticulation should be corrected in time.

The IgA1 proteases are a group of proteolytic enzymes, which are produced by pathogenic bacteria that infect and colonize mucosal surfaces. This group of proteolytic enzymes was found to cleave specific peptide bonds within the sequence TPPTPSPSTPPTPSPS (T, P and S are threonine, proline and serine residues, respectively) found in the hinge region of human IgA1. Several findings support the role of IgA1 protease, for example, its ability to cleave human LAMP1 (hLAMP1), TNF-RII, the CD8 molecule of T lymphocytes and granulocyte-macrophage colony-stimulating factor (GM-CSF), synaptobrevin II, hormone human chorionic gonadotropin, and its ability to exhibit important immunomodulatory properties, etc. , in particular the induction of proinflammatory cytokines. The IgA1 proteases have been found to instigate part of the T cell inflammatory response, especially to stimulate the release of cytokines such as tumour necrosis factor alpha (TNF-alpha), interleukin-1beta (IL-1beta), interleukin-6 (IL-6), and interleukin-8 (IL-8). All these suggest that this enzyme plays a significant role in pathogenesis. There are many other researches to explore new biological treatments of diseases using the biological characteristics of IgA1 protease.
Bacteria ; enzymology ; immunology ; pathogenicity ; Bacterial Infections ; enzymology ; immunology ; Humans ; Serine Endopeptidases ; adverse effects ; physiology ; Virulence

OBJECTIVEThis study was about the influence of porcelain thickness on crack at interface.

METHODSThe effect of porcelain thickness on the flaw at the interface between porcelain and metal was studied in three groups with porcelain thickness of 0.5 mm, 1.5 mm and 2.5 mm (metal thickness of 0.5 mm) by means of moire interferometre and interfacial fracture mechanics. The parameter Jc was compared among the three groups and the growing of the flaw was observed.

RESULTSJc and the extreme strength of group with porcelain thickness of 0.5 mm (2.813 N/m and 9.979 N) were lower than those of the groups with porcelain thickness of 1.5 mm and 2.5 mm (5.395 N/m, 19.134 N and 5.429 N/m, 19.256 N). Flaws extend along the interface in the groups with porcelain thickness of 1.5 mm and 0.5 mm.

CONCLUSIONS(1) Fracture resistance of the interface in the groups with porcelain thickness of 1.5 mm and 2.5 mm is similar and it decreases in the group with 0.5 mm thick porcelain. (2) When porcelain is 1.5 mm or 0.5 mm thick, flaws will extend along the interface. When porcelain is 2.5 mm thick, flaws will extend into the porcelain layer.

Objective:To construct and verify the occurrence model of acute respiratory distress syndrome (ARDS) using lung injury prediction score (LIPS) combined with acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and oxygenation index (PaO 2/FiO 2). Methods:Using a prospective cohort study method, 244 patients with complete medical records who were admitted to the intensive care unit (ICU) of Peking University Third Hospital from December 2020 to July 2022 were selected as research objects according to the inclusion and exclusion criteria. They were divided into training set (173 cases) and validation set (71 cases). Patients' gender, age, body mass index (BMI), various causes (shock, sepsis, craniocerebral injury, pulmonary contusion, multiple trauma, aspiration, pneumonia, acute abdomen, hypoproteinemia, acidosis, major surgery, etc.), underlying diseases (diabetes, malignant tumor, cerebrovascular disease, liver disease, kidney disease) and laboratory test indicators were collected. According to the above data, the LIPS score, APACHE Ⅱ score, sequential organ failure assessment (SOFA) and PaO 2/FiO 2, etc within 24 hours after admission to the ICU were calculated. Univariate analysis was used to screen the influencing factors for the occurrence of ARDS, and the factors with P < 0.2 were included in the multivariate Logistic regression analysis to screen out the independent predictive factors for the occurrence of ARDS. According to the results of multivariate Logistic regression analysis, the risk score of patients with ARDS was obtained to construct the risk prediction model of ARDS, the receiver operator characteristic curve (ROC curve) was drawn, and the area under the ROC curve (AUC) was calculated. The established ARDS prediction model was externally validated, and ROC curves were drawn to evaluate the predictive accuracy of the prediction model for the occurrence of ARDS in critically ill patients, and the AUC of the validation set was calculated to analyze the predictive performance of each risk factor on the occurrence of ARDS. Results:A total of 173 patients were enrolled in the training set, including 121 patients without ARDS and 52 patients with ARDS; 77 cases of acute abdomen, 64 cases of sepsis, 60 cases of shock, 51 cases of acidosis, 40 cases of hypoproteinemia, 37 cases of diabetes, 34 cases of craniocerebral injury, 34 cases of abnormal liver function, 28 cases of multiple trauma, 23 cases of malignant tumor, 23 cases of spinal orthopedic surgery, 17 cases of obesity, 12 cases of pneumonia, 11 cases of pulmonary contusion, and 7 cases of chronic kidney disease, chemotherapy in 6 cases, and aspiration in 2 cases. The rates of shock, sepsis, acute abdomen, acidosis, abnormal liver function, lung contusion, pneumonia and aspiration, gender, age, LIPS score, APACHE Ⅱ score, and SOFA score in the ARDS group were significantly higher than those in the non-ARDS group (all P < 0.05), moreover, PaO 2/FiO 2 ratio was significantly lower than that of non-ARDS group ( P < 0.01). Multivariate Logistic regression analysis showed that LIPS score, APACHE Ⅱ score, and PaO 2/FiO 2 ratio were independent risk factors for ARDS in ICU patients with high risk factors for ARDS, and the odds ratio ( OR) was 1.768 [95% confidence interval (95% CI) was 1.380-2.266], 1.242 (95% CI was 1.089-1.417), 0.985 (95% CI was 0.978-0.991), all P < 0.05. ROC curve analysis showed that the AUC of the ARDS prediction model training set was 0.920, the sensitivity was 86.5%, and the specificity was 86.8%; the AUC of the verification set was 0.896, the sensitivity was 96.8%, and the specificity was 76.6%. Conclusion:LIPS score, APACHE Ⅱ score and PaO 2/FiO 2 are independent risk factors for the occurrence of ARDS in ICU patients with high risk factors for ARDS. The ARDS risk prediction model established based on these three indicators has a good predictive ability for the occurrence of ARDS in critically ill patients, wihich needs to be verified by multicenter cohort studies.