Objective:To explore the effect of the enriched environment(EE)on pyroptosis in rats with cerebral ischemia-reperfusion injury(CIRI).Methods:45 male Sprague-Dawley rats were randomly divided into three groups: a sham surgery(Sham)group, a cerebral ischemia-reperfusion(CIR)group and an enriched environment(EE)group, with 15 rats in each group.Except for the Sham group, the right middle cerebral artery occlusion model was established in the other two groups.After surgery, the EE group was fed in EE, and the other two groups were fed in standard environment.All the rats were assessed using the modified neurological severity score(mNSS)before modeling and on the 1st day, 7th day and 14th day following surgery.On the 14th day after surgery, 2, 3, 5-triphenyltetrazolium chloride(TTC)staining was used to evaluate the infarct volume, hematoxylin and eosin(HE)staining was used to examine pathomorphological changes of the hippocampal CA1 region on the ischemic side of the rats in each group, immunohistochemical assay was used to detect the expression of nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)and cysteinyl aspartate specific proteinase-1(caspase-1)proteins in the CA1 region, and ultrastructural changes in neurons in the CA1 region were observed under transmission electron microscopy.Results:Compared with the Sham group, the mNSS scores of the CIR group and the EE group were significantly higher on the 1st day and 7th day after surgery( P<0.05), but there was no significant difference between the CIR and EE groups( P>0.05). On the 14th day after surgery, compared with the CIR group, the EE group showed a decrease in the mNSS score and the cerebral infarct volume( P<0.05), alleviated pathomorphological changes, decreased expression of NLRP3 and caspase-1 proteins( P<0.05), and alleviated pathological changes of pyroptosis in the ultrastructure of neurons. Conclusions:EE can reduce the damage of neurological function, reduce the cerebral infarct volume, and play a protective role for the brain in CIRI rats.The mechanism may be related to the down-regulation of the expression of NLRP3 and caspase-1 proteins related to the classical pyroptosis pathway, leading to the inhibition of pyroptosis.

The biological samples of oral genetic diseases and rare diseases are extremely precious. Collecting and preserving these biological samples are helpful to elucidate the mechanisms and improve the level of diagnose and treatment of oral genetic diseases and rare diseases. The standardized construction of biobanks for oral genetic diseases and rare diseases is important for achieving these goals. At present, there is very little information on the construction of these biobanks, and the standards or suggestions for the classification and coding of biological samples from oral and maxillofacial sources, and this is not conducive to the standardization and information construction of biobanks for special oral diseases. This consensus summarizes the background, necessity, principles, and key points of constructing the biobank for oral genetic diseases and rare diseases. On the base of the group standard "Classification and Coding for Human Biomaterial" (GB/T 39768-2021) issued by the National Technical Committee for Standardization of Biological Samples, we suggest 76 new coding numbers for different of biological samples from oral and maxillofacial sources. We hope the consensus may promote the standardization, and smartization on the biobank construction as well as the overall research level of oral genetic diseases and rare diseases in China.

Objective: To investigate the classification of atrophic glossitis and to study the correlation between the classification and changes of VitB12, folic acid (FOL) and blood cell parameters Methods: A total of 70 patients with atrophic glossitis (AG) were divided into complex type and simple type according to whether they had ulcer or erosion on the tongue mucosa or not. Another 65 healthy subjects during the same period were collected as the control group. The levels of vitamin B12, FOL and blood cell parameters were statistically analyzed using SPSS 25.0 software package. Results: The levels of vitamin B12, red blood cell count (RBC) (3.52 ± 0.69) × 1012·L-1, hemoglobin (HGB)(11.97 ± 1.70) g·dL-1, white blood cell count (WBC) (4.85 ± 1.16) × 109·L-1, neutrophil count (NEUT) (2.76 ± 0.99) × 109·L-1, lymphocyte count (LYMPH) (1.48 ± 0.44) × 109·L-1 in complex type AG group were lower than those in simple type AG group (P<0.05). The levels of mean red blood cell volume (MCV) (104.90 ± 11.13) fL, mean corpuscular hemoglobin (MCH) (34.83 ± 4.56) pg, mean corpuscular hemoglobin concentration (MCHC) (331.09 ± 13.60) g·L-1 were higher than those in the simple type AG group (P<0.05). There was no significant difference in FOL content between these two groups (P>0.05). The levels of VitB12, MCV, MCH, MCHC, WBC, lymph and neut were correlated with the classification of atrophic glossitis (P < 0.05). Conclusion VitB12 deficiency was more apparent in complex AG, especially in large cell anemia, which correlated with the levels of WBC, NEUT, and LYMPH.

Objective : To investigate the pathogenic factors and clinical manifestations of contact stomatitis, and to provide references for its clinical diagnosis and prevention. Methods: The data of 55 subjects with contact stomatitis were analyzed retrospectively, including age, gender, pathogenic factors, type of lesions and site of occurrence. Results: Among the 55 patients, contact stomatitis occurred at all ages, 19 were male, 36 were female, and the ratio of males to females was 1∶1.89. Among 55 patients, 78.18% (43/55) were caused by oral mucosal contact with dental materials: amalgam fillings accounted for 52.73% (29/55), metal crowns accounted for 9.09% (5/55), removable denture plastic bases accounted for 9.09% (5/55), resin fillings accounted for 5.45% (3/55), and alginate impression materials accounted for 1.82% (1/55); 21.82% (12/55) were caused by oral mucosal contact with food and daily necessities. The clinical manifestations of contact stomatitis include lichenoid reaction, erythema and erosion. The most common site of contact stomatitis was the cheek, followed by the tongue, and the lips, and the gingival and palatal areas were relatively rare. In the buccal mucosa, the incidence of lichenoid reaction was 55% (22/40), which was higher than that of erosion (20%) and erythema (25%), and the difference was statistically significant (P < 0.05). For tongue, lip, gingiva and palate, there was no significant difference in the incidence of the three lesion types（P > 0.05）. Conclusion Contact stomatitis occurred at all ages, and there are more female patients than males with contact stomatitis. Dental materials, especially metal and acrylic materials (such as the plastic base of removable dentures, resin fillings, adhesives, and self-setting plastics), are the main pathogenic factors. In buccal mucosa, the incidence of lichenoid reaction is higher.

Objective : To explore the potential association between particular living habits and recurrent aphthous ulcers (RAU), and provide some references for RAU prevention among the young and middle⁃aged. Methods: The mul⁃ tistage random sampling method was adopted to select 850 young and middle⁃aged people in Nanjing. The disease sta⁃ tus and living habits of young and middle⁃aged people with RAU in Nanjing were investigated by a questionnaire, and the influencing factors were analyzed by univariate and multivariate logistic regression analysis. Results: The preva⁃ lence of RAU was 20.5% among 799 individuals, including 357 men and 442 women. The risk of RAU at medium and low stress levels was 0.533 times and 0.419 times that at high stress levels, respectively (P < 0.05), indicating that high stress was an independent risk factor for RAU. The risk of RAU in patients with low exercise levels was 1.513 times that in patients with high exercise levels (P < 0.05), indicating that high exercise levels were a protective factor for RAU. There were no statistically significant differences in age, sex, smoking, drinking or bedtime (P > 0.05). Conclu⁃ sion Multivariate logistic regression showed that mental stress and physical activity were independent influencing fac⁃ tors for the development of RAU. The living habits of RAU patients and RAU susceptible populations should be treated with corresponding interventions to prevent RAU.

Recently,the incidence of chronic disease has been increasing rapidly every year,which contributes to heavy burdens on society. Chronic disease management（CDM）has become an effective solution. At present,CDM in China is still at an early age,without a widely accepted and efficient model for lack of theoretic and practical support. By analyzing and comparing CDM models in China and abroad,we summarizes that CDM in China needs to be guaranteed by government and law,strengthened by the construction of medical team,promoted by an integrated service network,and implemented by hierarchical diagnosis and treatment of multi-departments.

Objective: To investigate the incidence and prognosis of cognitive impairment and to find out the risk factors associated with the outcome for better understanding and preventing cognitive impairment in maintenance hemodialysis (MHD) patients. Methods: The patients who met the criteria as below: MHD patients (≥3 months) in Renji Hospital, Shanghai Jiao Tong University School of Medicine from January 2000 to July 2014, ≥18 years old were enrolled and could carry on the montreal cognitive assessment (MoCA) of voluntary cooperation. According to the score of MoCA, all enrolled patients were divided into two groups: cognitive impairment (MoCA<26) group and non-cognitive impairment (MoCA≥26) group. The follow-up period was 3 years. There were 130 males, and the incidence, demography data, medical history, hemodialysis data, laboratory examination and prognosis of cognitive impairment in hemodialysis patients were prospectively compared and analyzed. Logistic regression analysis was used to investigate the risk factors of cognitive impairment. Kaplan-Meier survival curve and Cox regression model were used for prognostic analysis. Results: A total of 219 MHD patients were enrolled. The incidence of cognitive impairment in MHD patients was 51.6%. There were 130 males, and the ratio of male to female was 1.46∶1. Age was (60.07±12.44) years old and dialysis vintage was (100.79±70.23) months. Compared with non-cognitive impairment group (n=106), patients in cognitive impairment group (n=113) were older, and had higher proportion of education status<12 years, history of diabetes and anuria (all P<0.05); however, the post-dialysis systolic pressure, pre-dialysis diastolic pressure, post-dialysis diastolic pressure, platelet and spKt/V were lower (all P<0.05). Multivariate logistic regression analysis showed that education status<12 years (OR=3.428, 95%CI 1.919-6.125, P<0.001), post-dialysis diastolic pressure<73 mmHg (OR=2.234, 95%CI 1.253-3.984, P=0.006) and spKt/V<1.72(OR=1.982, 95%CI 1.102-3.564, P=0.022) were the independent risk factors for cognitive impairment in MHD patients. The Kaplan-Meier survival curve analysis showed that the survival rate of patients with cognitive impairment was lower than that of non-cognitive impairment group in MHD patients during 3 years follow-up (χ²=3.977, P=0.046). Multivariate Cox regression analysis showed that cognitive impairment was an independent risk factor for death in MHD patients (RR=2.661, 95%CI 0.967-7.321, P=0.058). Conclusions Cognitive impairment is one of the common complications and an independent risk factor for death in MHD patients. The mortality is high in patients who suffer cognitive impairment. Education status<12 years, post-dialysis diastolic pressure<73 mmHg and spKt/V<1.72 are the independent risk factors for cognitive impairment in MHD patients.

Objective To design a pocket book on picture-aided communication in foreign-related nursing and to verify the clinical effect.Methods Contents of this pocket book were collected by literature retrieval and qualitative interview,and were improved by a two-round Delphi expert consultation. Comparison was conducted between patients in the experiment group and control group,each with 25 foreigners,about their communication time and satisfaction.Results In A pocket book on picture-aided communication in foreign-re-lated nursing,5 dimensions with 620 entries were included,with test-retest reliability of 0.816,and content validity 0.97. It was shown in clinical application that this pocket book could effectively improve communication efficiency and satisfaction between nurses and foreign patients (P<0.05).Conclusions A pocket book on pic-ture-aided communication in foreign-related nursing can help develop fast and effective communication between nurses and foreign patients,improve service quality of foreign-related nursing,and give a hand to develop level of international medical service in Shanghai.

Objective To investigate the selection of flaps for the reconstruction of facial skin defects.Methods A total of 40 patients with facial skin defects were treated from February 2011 to February 2015 in our hospital,and they were given different surgery methods ac-cording to the different facial skin defect sizes.Minor defects were primarily treated by direct suturing;medium-sized defects were treated by local skin flap transposition or island skin flap;and larger defects were treated by expanded skin flap.Results All patients were followed up for 1 to 2 years.All the flaps survived with good color and texture match.All the scars healed well which were almost invisible.There was no obvious deformity in the donor and recipient sites.In addition,there was no lesion recurred.Conclusion Select suitable flaps for the recon-struction of facial skin defects according to the face defect area could get reliable blood supply of the flap,inapparent incision scar and a high level of satisfaction.

Objective To investigate nursing students′ cultural ability of two Shanghai vocational colleges in order to provide the scientific basis of teaching methods and clinical practice for improving nursing students′cultural ability. Methods By adopting inventory for assessing the process of cultural competence among health care professionals revised ( IAPCC-R ) , 529 nursing students in two vocational colleges were investigated. Results The average score of nursing students′cultural competence was (65. 53 ± 6. 50), 91. 1%of the students were in general level; 8. 1% of the students were in high level, 0. 8% nursing students were without cultural competence, no one was found as a proficient person in this area. There was significant difference between students in different colleges (t=3. 714,P<0. 001); There was no significant difference among students in different grades (F=3. 714,P=0. 452). Conclusions Generally nursing students′ cultural ability in Shanghai was not high, so efforts are needed to increase the humanities curriculums in colleges and teaching staffs′culture ability as well as the examinations of cultural ability, which are very important for nursing students to provide professional humanistic care services for patients after they work in hospital as nurses.