Oral frailty and cognitive impairment are the common geriatric syndromes.There may be similar correlation mechanism between them,which are related with polypharmacy,malnutrition,inflammato-ry responses and psychosocial factors.The occurrence of oral frailty could potentially increase the risk of cog-nitive impairments,in which tooth loss,reduced chewing function,swallowing difficulties,low tongue pres-sure,and diminished oral motor function are closely correlated with cognitive impairments.Understanding the correlation between the two is conducive to prevent and interfere the healthy status in elderly people,thus in-crease their quality of life and health level.

[摘 要] 目的：探讨橙花叔醇通过Wnt-β-catenin通路抑制黑色素瘤A-375和WM-115细胞恶性生物学行为的分子机制。方法: 体外培养黑色素瘤细胞A-375和WM-115，用不同浓度的橙花叔醇处理，采用SRB法和克隆形成实验、FCM术、Transwell实验和细胞划痕实验、DCFH-DA染色法、qPCR和WB法分别检测橙花叔醇对A-375和WM-115细胞的增殖能力、细胞周期和凋亡、迁移能力、活性氧（ROS）水平和Wnt-β-catenin通路及其下游相关基因和相关蛋白表达的影响。利用ULCAN和GEPIA2数据库分析黑色素瘤中Wnt-β-catenin通路的激活与患者预后的关系。结果：与对照组比较，橙花叔醇处理组A-375和WM-115细胞的增殖能力受明显抑制（均P<0.01）、细胞周期阻滞于G2/M期（P<0.05或P<0.01）、细胞凋亡率增加（均P<0.01）、迁移能力降低（P<0.05或P<0.01）、ROS水平升高（均P<0.01）、Wnt-β-catenin通路被抑制而其下游基因和蛋白表达明显上调（均P<0.01）。数据库数据分析显示，WNT1基因高表达患者OS低于低表达患者（P<0.01）。结论：橙花叔醇通过上调A-375和WM-115细胞中ROS水平影响Wnt-β-catenin通路，从而抑制其恶性生物学行为；Wnt-β-catenin通路可能是黑色素瘤治疗的潜在靶点。

Background: Inflammatory bowel disease (IBD) is a chronic recurrent inflammatory disease of gastrointestinal tract including ulcerative colitis (UC) and Crohn's disease (CD). It is unclear whether there is a causal association between unsaturated fatty acids and IBD. Aims: A two⁃sample Mendelian randomization analysis was used to explore the causal association between unsaturated fatty acids and IBD. Methods: The data of the genome⁃wide association study (GWAS) of unsaturated fatty acids and IBD were obtained from web⁃based public databases. Two⁃sample Mendelian randomization analysis was performed by using inverse⁃variance weighted analysis, and weight median estimator and MR⁃Egger regression were conducted to validate the association of the causal effect. The causality of unsaturated fatty acids on the risk of IBD was evaluated by OR and 95% CI. Results: No direct causal association was found between ω⁃6 fatty acids and CD, and a direct causal association was found with UC. Inverse⁃variance weighted analysis showed a 16% increase in the risk of UC for each standard deviation increase in ω⁃6 fatty acid gene levels (OR=1.16, 95% CI: 1.00⁃1.36, P=0.04). However, no causal association was found between ω⁃3 fatty acids, monounsaturated fatty acids and IBD. Conclusions: ω⁃6 fatty acids may be only causally associated with UC, and no causal association is found between ω⁃3 fatty acids, monounsaturated fatty acids and IBD.

Objective:To study the expressions of heat shock protein (HSP) 90α and HSP90β in colorectal cancer and paracancer tissues, and to investigate the relationships between HSP90α, HSP90β and clinicopathological features of colorectal cancer patients, and to analyze their correlation.Methods:The tumor tissues and paracancer tissues of 117 patients with colorectal cancer were selected from the Department of Gastrointestinal Surgery, Third Affiliated Hospital of Shandong First Medical University from January 2016 to December 2020. The expression levels of HSP90α and HSP90β were detected by immunohistochemistry, and the relationships between the two proteins and clinicopathological features and the correlation of their expressions were analyzed.Results:The positive expression rates of HSP90α in colorectal cancer tissues and paracancer tissues were 74.4% (87/117) and 12.0% (14/117) , and there was a statistically significant difference ( χ2=92.83, P<0.001) . The positive expression rate of HSP90β in colorectal cancer tissues and paracancer tissues was 61.5% (72/117) and 10.3% (12/117) , and there was a statistically significant difference ( χ2=66.86, P<0.001) . The expression of HSP90α was correlated with tumor location ( χ2=8.67, P=0.003) , vascular invasion ( χ2=8.68, P=0.003) , lymph node metastasis ( χ2=8.52, P=0.004) , T stage ( χ2=21.07, P<0.001) , N stage ( χ2=11.94, P=0.003) , M stage ( χ2=5.37, P=0.020) , pathological stage ( χ2=25.64, P<0.001) . The expression of HSP90β was correlated with lymph node metastasis ( χ2=4.03, P=0.045) , T stage ( χ2=11.09, P=0.007) , N stage ( χ2=6.56, P=0.038) , M stage ( χ2=12.43, P<0.001) , pathological stage ( χ2=17.34, P=0.001) . There was a positive correlation between the expressions of the two proteins in colorectal cancer tissues ( r=0.42, P<0.001) . Conclusion:The expressions of HSP90α and HSP90β in colorectal cancer tissues are significantly higher than those in paracancer tissues, and they are related to lymph node metastasis and pathological stage. There is a positive correlation between the two proteins, which may be involved in the occurrence and development of colorectal cancer and are expected to become new tumor markers.

Objective:To explore the value of nursing checklist in posterior surgery for thoracolumbar fracture with general anesthesia under prone position.Methods:A retrospective case series study was conducted to analyze the clinical data of 106 patients with thoracolumbar fracture admitted to Sir Run Run Shaw Hospital，Zhejiang University School of Medicine from June 2018 to May 2020. There were 80 males and 26 females，with age range of 25-57 years［（48.6 ± 11.9）years］. Segments of injury were located at T 11 in 18 patients，at T 12 in 26，at L 1 in 21，at L 2 in 25 and at L 3 in 16. All patients were treated with thoracolumbar posterior screw fixation under general anesthesia. Of all，51 patients received conventional postural nursing from June 2018 to May 2019（control group），and 55 patients received prone position nursing scheme for general anesthesia on the basis of conventional postural nursing from June 2019 to May 2020（verification group）. The incidence of postoperative complications including stress injury，brachial plexus injury，ulnar nerve injury and ocular discomfort as well as length of hospital stay and patients’ satisfaction were compared between the two groups. Visual analogue scale（VAS）and Oswestry disability index（ODI）were also used to measures outcome at postoperative 3 months. Results:All patients were followed up for 8-12 months［（10.5±0.9）months］. Verification group and control group showed significant differences in the incidence of stress injury（4%∶29%），brachial plexus injury（4%∶16%）and ocular discomfort consisiting of tears（2%∶12%），foreign body sensation（0%∶4%）and dryness（4%∶16%）（ P < 0.05），not in ulnar nerve injury and blurred vision. Length of hospitalization in verification group was（7.0±1.3）days，significantly shorter than that in control group［（9.9±1.9）days］（ P < 0.05）. Satisfaction of patients in verification group and control group was 85%（47/55）and 69%（35/51），respectively（ P < 0.05）. At 3 months postoperatively，VAS in verification group［（1.9 ± 0.8）points］was significantly lower than that in control group［（3.5±1.1）points］（ P < 0.05），and ODI was similar between the two groups（ P > 0.05）. Conclusions For patients with thoracolumbar fracture treated by posterior surgery with general anaesthesia under prone position，nursing checklist helps reduce occurrence of the related complication，shorten length of hospital stay，improve patient satisfaction，reduce postoperative pain and promote rehabilitation.

As the operation volume in hospitals is increasing year by year, surgical instruments are widely used, which pose a great challenge to the daily management of surgical instruments. The authors investigated the existing problems which occurred in the management of surgical instruments, and came out with instruments coding navigation index and specialized placement scheme for the operating room as solutions. The specific measures included dividing sterile items into specialized categories, setting cabinets respectively for specialized and general subjects, building equipment coding and identification, establishing surgical instruments navigation index and carrying out training program, to serve as reference for efficient and fine management of surgical instruments.

Biomineralization is the process by which organisms form mineralized tissues with hierarchical structures and excellent properties, including the bones and teeth in vertebrates. The underlying mechanisms and pathways of biomineralization provide inspiration for designing and constructing materials to repair hard tissues. In particular, the formation processes of minerals can be partly replicated by utilizing bioinspired artificial materials to mimic the functions of biomolecules or stabilize intermediate mineral phases involved in biomineralization. Here, we review recent advances in biomineralization-inspired materials developed for hard tissue repair. Biomineralization-inspired materials are categorized into different types based on their specific applications, which include bone repair, dentin remineralization, and enamel remineralization. Finally, the advantages and limitations of these materials are summarized, and several perspectives on future directions are discussed.
Biomineralization

Tooth enamel is prone to be attacked by injurious factors, leading to a de/remineralization imbalance. To repair demineralized enamel and prevent pulp inflammation caused by biofilm accumulation, measures are needed to promote remineralization and inhibit bacterial adhesion on the tooth surface. An innovative material, poly (aspartic acid)-polyethylene glycol (PASP-PEG), was designed and synthesized to construct a mineralizing and anti-adhesive surface that could be applied to repair demineralized enamel. A cytotoxicity assay revealed the low cytotoxicity of synthesized PASP-PEG. Adsorption results demonstrated that PASP-PEG possesses a high binding affinity to the hydroxyapatite (HA)/tooth surface. In vitro experiments and scanning electron microscopy (SEM) demonstrated a strong capacity of PASP-PEG to induce in situ remineralization and direct the oriented growth of apatite nanocrystals. Energy dispersive X-ray spectroscopy (EDS), X-ray diffraction analysis (XRD) and Vickers hardness tests demonstrated that minerals induced by PASP-PEG were consistent with healthy enamel in Ca/P ratio, crystal form and surface micro-hardness. Contact angle tests and bacterial adhesion experiments demonstrated that PASP-PEG yielded a strong anti-adhesive effect. In summary, PASP-PEG could achieve dual effects for enamel repair and anti-adhesion of bacteria, thereby widening its application in enamel repair.

Blood pressure is an important physiological index that can reflect the function of the heart and blood vessels. Compared with other methods, oscillometric measurement has the advantages of strong noise immunity, simple operation and low cost, which is the most widely used technology for blood pressure measurement. In this paper, we reviewed and discussed the key technologies of measuring blood pressure, such as pre-processing method of oscillation envelope and blood pressure estimation technique. The latter include traditional wave method, waveform morphology method, the methods based on the model and machine learning. At last, we have a look forward to its future development direction.
Blood Pressure ; Blood Pressure Determination ; instrumentation ; Heart ; Oscillometry ; Technology

Objective To investigate the effect of intravenous infusion of lidocaine on postoperative analgesia in patients undergoing laparoscopic total hysterectomy.Methods Eighty patients aged 28-65 years undergoing laparoscopic total hysterectomy were randomly divided into 2 groups (n=40 each):lidocaine group (group L) and control group (group C).In group L,patients assigned to received an intravenous bolus infusion of 1.5 mg/kg of lidocaine,then followed by 2 mg·kg-1 ·h-1 until the end of operation.Group C received an equal volume of normal saline (100 ml).The patients received patient-controlled intravenous analgesia (PCIA) of snfentanil after surgery,maintaining VAS score≤3.The Ramsay sedation scores and Bruggrmann comfort scale (BCS) at 2,4,8,12,24 and 48 h after operation were recorded.The consumption of sufentanil within 24 h after operation,the dose of extra sufentanil,the number of delivered doses,the times of postoperative firstly flatus and defecation,the incidence of postoperative nausea and vomiting,and total hospital stay were also observed.Results Compared with group C,the Ramsay sedation scores and BCS was increased,the consumption of sufentanil within 24 h after operation [(34.8±5.8)μg vs (49.8±12.5)μg],the dose of extra sufentanil [(22.5 ± 2.6) μg vs (46.2 ± 3.8) μg],the number of delivered doses [(20 ± 4)times vs (48± 6) times] was significantly decreased (P ＜ 0.05),the time of postoperative firstly flatus [(17±6)h vs (27±7)h] and defecation [(26±8)h vs (47±9)h] and total hospital stay [(4.5±0.5)d vs (5.6±0.8)d] was significantly shortened (P＜0.05),and the incidence of postoperative nausea (5％ vs 20％) were significantly decreased (P＜0.05) in group L.Conclusion Intravenous infusion of lidocaine can enhance postoperative analgesia and reduce the volume of opioid analgesics,and was beneficial for peristalsis and hospital for patients undergoing laparoscopic total hysterectomy.