Objectives:To investigate whether the use of inlays and onlays made of 3 different materials respectively increases the risk of distal root fracture in mandibular second molars with alveolar bone resorption after root canal treatment.Methods:A 3D fi-nite element analysis(3D FEA)model of distal alveolar bone resorption in mandibular second molars was established using Micro-CT,Mimics21.0,geomagic and ANSYS17.0.3 types of materials(resin nanoceramic Lava ultimate,lithium disilicate ceramics e.max CAD and yttria-stabilized zirconia ceramic e.max Zir CAD)inlays and onlays were utilized for the application of vertical and 45° force loadin respectively.The von-Mises stress distribution on the models was analyzed.Results:Among the models,it was ob-served that cusp-covering onlay model demonstrated minimal Von Mises stresses at distal roots.Lava Ultimate exhibited the highes levels of Von Mises stress than other 2 materials,the stress was more concentrated towards upper parts of distal roots.Conclusion:When distal caries occur below the CEJ of mandibular second molars and are accompanied by alveolar bone resorption,the utilization of cusp-covering onlays and resin nanoceramics can reduce the risk of root fracture in the distal apical region.

Objective:To develop a nutritional management protocol for head and neck cancer (HNC) patients undergoing radiotherapy based on evidence-based methodology, and to evaluate its clinical effectiveness.Methods:Relevant literature on nutritional management in radiotherapy for HNC patients was systematically searched. After evidence extraction, a preliminary protocol was drafted and finalized through expert consensus. The finalized protocol included five timepoints during hospitalization, covering six components and 35 nursing and clinical care items. A quasi-experimental design was adopted. Using convenience sampling, 100 HNC patients admitted to Jinhua Municipal Central Hospital from October 2022 to June 2024 were enrolled. Patients treated between October 2022 and July 2023 formed the control group ( n=50), and those treated from September 2023 to June 2024 comprised the intervention group ( n=50). The control group received routine care, while the intervention group was managed with the evidence-based nutrition protocol. Body weight and nutrition-related laboratory indicators were measured before radiotherapy, at week 4, and at the end of week 6. Results:At week 4 of radiotherapy, the intervention group had a higher lymphocyte count than the control group, with statistically significant differences ( P<0.05). At week 6, total serum protein, serum albumin, and lymphocyte counts were all higher in the intervention group, with statistically significant differences ( P<0.05) . Conclusions:The evidence-based nutritional management protocol developed for HNC patients undergoing radiotherapy effectively improves nutritional status. It provides a valuable reference for healthcare professionals in clinical practice.

Objective:To develop a nutritional management protocol for head and neck cancer (HNC) patients undergoing radiotherapy based on evidence-based methodology, and to evaluate its clinical effectiveness.Methods:Relevant literature on nutritional management in radiotherapy for HNC patients was systematically searched. After evidence extraction, a preliminary protocol was drafted and finalized through expert consensus. The finalized protocol included five timepoints during hospitalization, covering six components and 35 nursing and clinical care items. A quasi-experimental design was adopted. Using convenience sampling, 100 HNC patients admitted to Jinhua Municipal Central Hospital from October 2022 to June 2024 were enrolled. Patients treated between October 2022 and July 2023 formed the control group ( n=50), and those treated from September 2023 to June 2024 comprised the intervention group ( n=50). The control group received routine care, while the intervention group was managed with the evidence-based nutrition protocol. Body weight and nutrition-related laboratory indicators were measured before radiotherapy, at week 4, and at the end of week 6. Results:At week 4 of radiotherapy, the intervention group had a higher lymphocyte count than the control group, with statistically significant differences ( P<0.05). At week 6, total serum protein, serum albumin, and lymphocyte counts were all higher in the intervention group, with statistically significant differences ( P<0.05) . Conclusions:The evidence-based nutritional management protocol developed for HNC patients undergoing radiotherapy effectively improves nutritional status. It provides a valuable reference for healthcare professionals in clinical practice.

Objectives:To investigate whether the use of inlays and onlays made of 3 different materials respectively increases the risk of distal root fracture in mandibular second molars with alveolar bone resorption after root canal treatment.Methods:A 3D fi-nite element analysis(3D FEA)model of distal alveolar bone resorption in mandibular second molars was established using Micro-CT,Mimics21.0,geomagic and ANSYS17.0.3 types of materials(resin nanoceramic Lava ultimate,lithium disilicate ceramics e.max CAD and yttria-stabilized zirconia ceramic e.max Zir CAD)inlays and onlays were utilized for the application of vertical and 45° force loadin respectively.The von-Mises stress distribution on the models was analyzed.Results:Among the models,it was ob-served that cusp-covering onlay model demonstrated minimal Von Mises stresses at distal roots.Lava Ultimate exhibited the highes levels of Von Mises stress than other 2 materials,the stress was more concentrated towards upper parts of distal roots.Conclusion:When distal caries occur below the CEJ of mandibular second molars and are accompanied by alveolar bone resorption,the utilization of cusp-covering onlays and resin nanoceramics can reduce the risk of root fracture in the distal apical region.

Objective:To observe the susceptibility factors of elderly patients with corynebacterium striata in sputum of lower respiratory tract and analyze its clinical therapeutic effect.Methods:The clinical data of 192 elderly inpatients infected with corynebacterium striatum detected in sputum of lower respiratory tract were retrospectively analyzed in Quanzhou First Hospital Affiliated to Fujian Medical University from January 2019 to June 2021.The detection rate of corynebacterium striata was calculated, and the susceptibility factors and clinical efficacy were compared between the infection group(n=102)and the colonization group(n=90).Results:The detection rate of corynebacterium striata(detected cases / numbers of qualified lower respiratory tract sputum specimen)was 0.8%(72/8976)from January to December 2019, 2.3%(134/5877)from January to December 2020, and 3.0%(121/4 039)from January to June 2021, the difference was statistically significant( χ2=93.93, P<0.01). The detection rates of corynebacterium striatum during three corresponding periods in elderly patients were 0.6%(57/8 976), 1.4%(81/5 877)and 1.9%(78/4 039), respectively, with statistically significant differences( χ2=45.57, P<0.01). The incidences or values of following indexes were higher in infection group than in colonization group: age of patients, admission of intensive care unit, malnutrition, use of hormones, combined use of antibiotics, use of invasive mechanical ventilation, use of fiber bronchoscope, reduced cough reflex, other basic diseases, and so on, but the differences were not statistically significant(all P>0.05). The clinical effective rates were 41.2%(42/102)in the infection group and 48.9%(44/90)in the colonization group, respectively, and the differences was not statistically significant( P>0.05). Only 25 patients(24.5%)in the infected group were treated on corynebacterium striatum according to drug sensitivity results.Among them, the clinical effective rate of the treatment group and the untreated group was 68.0%(17/25)and 32.5%(25/77), respectively, the difference was statistically significant( χ2=9.84, P<0.01). The clinical effective rate of untreated group was lower than that of colonization group, the difference was statistically significant( χ2=4.62, P<0.05). Conclusions:The detection rate of corynebacterium striatum in elderly patients is high, and increases year by year.Patients infected with corynebacterium striatum usually has a variety of susceptibility factors, if not taking effective treatment measures, may have adverse outcomes.In clinical work, it is necessary to pay attention to and reduce the susceptibility factors of corynebacterium striatum, and to correctly interpret the etiological reports, so as to adopt a reasonable and effective therapeutic schedule.

Objective:We try to screen out predictive indicators with higher value by analyzing the differences in clinical and laboratory indicators between severe fever with thrombocytopenia syndrome (SFTS) patients in the intensive care unit (ICU) group and non-ICU group.Methods:The clinical and laboratory index data of 69 SFTS patients diagnosed in the laboratory in a hospital from June to December 2019 were retrospectively collected. According to the clinical outcome of the patients, they were divided into ICU and non-ICU groups. The differences in clinical manifestations and laboratory indicators between the two groups were analyzed. The receiver operating characteristic curve (ROC) was used to screen the more valuable predictive indicators.Results:Compared with the non-ICU group, ICU group SFTS patients had significantly higher procalcitonin (PCT), C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), glutamyl transpeptidase (GGT), leucine aminopeptidase (LAP), glutamate dehydrogenase (GDH), adenosine deaminase (ADA), cystatin C (Cys C), α-hydroxybutyrate dehydrogenase (α-HBDH), creatine kinase (CK), lactate dehydrogenase (LDH) levels ( W=530.0, P=0.003; W=496.5, P=0.015; W=496.0, P=0.015; W=535.5, P=0.002; W=545.5, P=0.001; W=498.5, P=0.013; W=537.0, P=0.002; W=523.0, P=0.004; W=512.0, P=0.007; W=502.0, P=0.012; W=486.0, P=0.023; W=509.0, P=0.008; W=541.0, P=0.002) and significantly lower platelet count (PLT), indirect bilirubin (IBIL), albumin/globulin ratio(A/G) and superoxide dismutase (SOD) levels ( W=199.0, P=0.024; W=175.5.5, P=0.009; t=-2.9, P=0.004; W=209.5, P=0.036; t=-3.0, P=0.004). ROC result showed that ALP [area under the curve (AUC)=0.804, 95% confidence interval ( CI) (0.679~0.929)] and LDH [AUC=0.805, 95% CI (0.680~ 0.930)] have a higher value for predicting the risk of severe illness. Conclusions:Abnormal liver function, heart function, and renal function indicators in SFTS patients indicate that patients are at risk of exacerbation. Among them, ALP and LDH levels have higher predictive value for risk of severe disease, suggesting that the monitoring of patients with the above symptoms should be strengthened in the clinical nursing process.

OBJECTIVE: To investigate the change of pulmonary ventilation function in patients with simple type and complex type pneumoconiosis based on high resolution computed tomography(HRCT). METHODS: A total of 188 male patients with pneumoconiosis were selected as the study subjects by judgment sampling method. Patients were divided them into simple type group(104 cases) and complex type group(84 cases) according to their chest HRCT findings. Another 80 healthy men who have no dust and other occupational hazard exposure were selected as the control group. The lung function tests were performed in patients in these three groups. RESULTS: The indexes of pulmonary function including vital capacity, forced vital capacity(FVC), forced expiratory volume in one second(FEV_1), FEV_1/FVC%, peak expiratory flow, forced expiratory flow at 25% of FVC exhaled, forced expiratory flow at 50% of FVC exhaled, forced expiratory flow at 75% of FVC exhaled and forced expiratory flow at 25% to 75% of vital capacity were lower in patients with pneumoconiosis of simple type and complex type groups than that in the control group(all P<0.01). The above indexes in the complex type group were lower than that in the simple type group(all P<0.01). The detection rate of pulmonary ventilation dysfunction in patients with pneumoconiosis was 64.9%. Among them, the detection rate of obstructive, restrictive and mixed ventilation dysfunction were 33.5%, 5.3% and 26.1%, respectively. The detection rates of pulmonary ventilation dysfunction and mixed ventilation dysfunction were higher in complex type group than that in simple type group(82.1% vs 51.0%, 41.7% vs 13.5%, all P<0.01). The severe and extremely severe pulmonary ventilation dysfunction was higher in complex type group than that in simple group(20.2% vs 8.6%, 21.4% vs 3.8%, all P<0.05). CONCLUSION: The types of pulmonary ventilation dysfunction in patients with pneumoconiosis are mainly obstructive and mixed. The pulmonary ventilation dysfunction tends to develop from obstructive to mixed with the increasing severity of pneumoconiosis. The pulmonary ventilation dysfunction in patients with complex type pneumoconiosis is more serious than that in patients with simple type pneumoconiosis. The HRCT image classification is related to the status of patients' pulmonary ventilation dysfunction.

Objective To analyze the causes for the biological monitoring abnormal results of the pressure steam sterilizer to eliminate non-standard operation and hidden risks during biological monitoring.Methods Totally 34 secondary or above medical institutions in Chongqing were selected randomly,and questionnaire survey was carried out over biological monitoring abnormal results and main influencing factors of the pressure steam sterilizer.Results Of the 126 abnormal results,there were 63 positive results (accounting for 50％) and the main influencing factors included expiration,aged seal ring,low-efficiency vacuum pump,nonstandard loading,bioindicator reproduction before sterilization,false positive result,polluted moist incubator and etc;There were 35 cases of results related to fast reader (accounting for 27.78％) and the main factors consisted of failure of reading light,improper input of bioindicator,dusts in the reading hole and etc;There were 18 cases of bioindicator discoloration before culture (accounting for 14.28％) and the main factor was reproduction occurred before the gemma was inactivated;There were l0 cases of nondiscoloring in case of positive control (accounting for 7.94％) and the main factors included non-crushed indicating mediostratum cultured in the incubator,insufficient shaking after crushing mediostratum and etc.Conclusion The main factors for abnormal biological monitoring of the sterilizer involve in equipment,personnel and material,and the quality control has to be executed from the three aspects.

Objective: To provide the methods and evidence for the treatment of patients with renal insufficiency and hyperuricemia, and explore the key points of work for clinical pharmacists.Methods: By participating in the treatment of one case of cervical cancer complicated with renal insufficiency and hyperuricemia, clinical pharmacist helped physician choose appropriate drugs and dosage, and monitored the patient with pharmaceutical care.Results: After the treatment, the blood uric acid decreased and renal function returned to normal, and the chemotherapy was completed successfully without obvious side effects.Conclusion: Clinical pharmacists participating in making individual therapeutic scheme can provide safe and effective medication care for patients and reduce adverse reactions.

Aim To investigate the effects of atorvas-tatin ( ATV) on activation and injury of microvascular endothelial cells induced by oxidized low density lipo-protein ( ox-LDL) . Methods Cultured human micro-vascular endothelial cells were pre-incubated with ATV for 24 h prior to exposure of endothelial cells to ox-LDL. After exposure of endothelial cells to ox-LDL, the cell viability was measured by MTT method, LDH in supernatants was determined by enzyme activity as-say kit, ICAM-1 in supernatants was assayed by using ELISA method, phosphorylation of NF-κB p65 was de-tected by western blot analysis, transcriptional activity of NF-κB signal pathway was measured by employing dual-luciferase reporter assay system. Results Hu-man microvascular endothelial cells were activated and injured by ox-LDL. Inhibition of the cell viability, re-lease of LDH, expression of ICAM-1, phosphorylation of NF-κB p65 , and up-regulated transcriptional activity of NF-κB induced by ox-LDL were attenuated by ATV. Conclusion ATV can significantly inhibit the activa-tion and injury of human microvascular endothelial cells induced by ox-LDL, and that may be related to inhibition of phosphorylation and transcriptional activity of NF-κB.