BACKGROUND:Polylactic acid(PLA)has good biocompatibility and a controllable degradation rate and is currently widely used in biomedical engineering.However,PLA has shortcomings such as low mechanical strength and insufficient biological activity,which limits its further application in bone tissue engineering. OBJECTIVE:To construct polylactic acid/polydopamine/tantalum(PLA/PDA/Ta)bone tissue engineering scaffolds,and explore their biosafety and in vitro osteogenesis. METHODS:A PLA scaffold with a porous structure was prepared through liquid crystal display light-curing technology.PLA/PDA scaffolds and PLA/PDA/Ta scaffolds were prepared by soaking PLA scaffolds in dopamine solution and dopamine-tantalum nanoparticle solution,respectively.The microstructure and water contact angle of scaffolds were characterized.MC3T3-E1 cells were co-cultured with PLA,PLA/PDA,and PLA/PDA/Ta scaffolds,respectively,and CCK-8 assay and live/dead cell staining were performed.After osteogenic differentiation,alkaline phosphatase,alizarin red staining,and osteogenic gene detection were performed. RESULTS AND CONCLUSION:(1)The scanning electron microscope results exhibited that the three kinds of prepared scaffolds had an interconnected porous three-dimensional structure,and the average pore diameter was 200 μm.The water contact angle of PLA/PDA/Ta scaffolds was lower than that of PLA and PLA/PDA scaffolds(P<0.05).(2)CCK-8 assay showed that compared with PLA and PLA/PDA scaffolds,PLA/PDA/Ta scaffolds could promote cell proliferation(P<0.05).Live/dead cell staining showed good cell proliferation in the three groups.(3)Alkaline phosphatase and alizarin red staining showed that compared with PLA and PLA/PDA scaffolds,PLA/PDA/Ta scaffolds could promote the expression of alkaline phosphatase and the formation of mineralized nodules.RT-qPCR showed that compared with PLA and PLA/PDA scaffolds,PLA/PDA/Ta scaffolds could enhance the mRNA expression of cell bone morphogenetic protein,Runx-2,and type I collagen(P<0.05,P<0.01).(4)The results showed that the PLA/PDA/Ta scaffold had excellent osteogenic activity and the ability to promote cell proliferation.

OBJECTIVE To improve the efficiency and quality of dispensed oral drug management in the inpatient pharmacy， and ensure the safety of drug use in patients. METHODS SWOT （strength， weakness， opportunity， threat） analysis method was used to analyze the internal strengths and weaknesses， as well as the external opportunities and threats in the construction of a closed-loop management system for dispensed oral drugs in the inpatient pharmacy of our hospital， and propose improvement strategies. RESULTS & CONCLUSIONS A refined， full-process， closed-loop traceability management system for dispensed oral drugs in the inpatient pharmacies was successfully established， which is traceable in origin， trackable in destination， and accountable in responsibility. After the application of this system， the registration rate of dispensed drug information and the correctness rate of registration content both reached 100%. The proportion of overdue drug varieties in the same period of 2024 decreased by 77.78% compared to March 2020， the inventory volume decreased by 29.50% compared to the first quarter of 2020， the per-bed medication volume decreased by 32.14% compared to the first quarter of 2020； the average workload per post in the same period of 2023 increased by 49.09% compared to 2019， the dispensing accuracy rate reached 100%， and the improvement rate of quality control problem increased by 25.25% compared to 2021. This system effectively improves the safety and accuracy of dispensed oral drug management in the inpatient pharmacy.

OBJECTIVE: To prepare decellularized nerve grafts from alpha-1, 3-galactosyltransferase (GGTA1) gene-edited pigs and explore their biocompatibility for xenotransplantation. METHODS: The sciatic nerves from wild-type pigs and GGTA1 gene-edited pigs were obtained and underwent decellularization. The alpha-galactosidase (α-gal) content in the sciatic nerves of GGTA1 gene-edited pigs was detected by using IB4 fluorescence staining and ELISA method to verify the knockout status of the GGTA1 gene, and using human sciatic nerve as a control. HE staining and scanning electron microscopy observation were used to observe the structure of the nerve samples. Immunofluorescence staining and DNA content determination were used to evaluate the degree of decellularization of the nerve samples. Fourteen nude mice were taken, and subcutaneous capsules were prepared on both sides of the spine. Decellularized nerve samples of wild-type pigs ( n=7) and GGTA1 gene-edited pigs ( n=7) were randomly implanted in the subcutaneous capsules. Blood was drawn at 1, 3, 5, and 7 days after implantation to detect neutrophil counting. RESULTS: IB4 fluorescence staining and ELISA detection showed that GGTA1 gene was successfully knocked out in the nerves of GGTA1 gene-edited pigs. HE staining showed that the structure of the decellularized nerve from GGTA1 gene-edited pigs was well preserved; the nerve basement membrane tube structure was visible under scanning electron microscopy; no cell nuclei was observed, and the extracellular matrix components was retained in the nerve grafts by immunofluorescence staining; and the DNA content was significantly reduced when compared with the normal nerves ( P<0.05). In vivo experiments showed that the number of neutrophils in the two groups were similar at 1, 3, and 7 days after implantation, with no significant difference ( P>0.05); only at 5 days, the number of neutrophils was significantly lower in the GGTA1 gene-edited pigs than in the wild-type pigs ( P<0.05). CONCLUSION The decellularized nerve grafts from GGTA1 gene-edited pigs have well-preserved nerve structure, complete decellularization, retain the natural nerve basement membrane tube structure and components, and low immune response after xenotransplantation through in vitro experiments.
Animals ; Transplantation, Heterologous ; Galactosyltransferases/genetics* ; Sciatic Nerve/immunology* ; Swine ; Tissue Engineering/methods* ; Humans ; Graft Rejection/prevention & control* ; Gene Editing ; Mice ; Mice, Nude ; Heterografts/immunology* ; Animals, Genetically Modified ; Tissue Scaffolds ; Decellularized Extracellular Matrix

OBJECTIVE: To develop an original-mirror alignment associated deep learning algorithm for intelligent registration of three-dimensional maxillofacial point cloud data, by utilizing a dynamic graph-based registration network model (maxillofacial dynamic graph registration network, MDGR-Net), and to provide a valuable reference for digital design and analysis in clinical dental applications. METHODS: Four hundred clinical patients without significant deformities were recruited from Peking University School of Stomatology from October 2018 to October 2022. Through data augmentation, a total of 2 000 three-dimensional maxillofacial datasets were generated for training and testing the MDGR-Net algorithm. These were divided into a training set (1 400 cases), a validation set (200 cases), and an internal test set (200 cases). The MDGR-Net model constructed feature vectors for key points in both original and mirror point clouds (X, Y), established correspondences between key points in the X and Y point clouds based on these feature vectors, and calculated rotation and translation matrices using singular value decomposition (SVD). Utilizing the MDGR-Net model, intelligent registration of the original and mirror point clouds were achieved, resulting in a combined point cloud. The principal component analysis (PCA) algorithm was applied to this combined point cloud to obtain the symmetry reference plane associated with the MDGR-Net methodology. Model evaluation for the translation and rotation matrices on the test set was performed using the coefficient of determination (R²). Angle error evaluations for the three-dimensional maxillofacial symmetry reference planes were constructed using the MDGR-Net-associated method and the "ground truth" iterative closest point (ICP)-associated method were conducted on 200 cases in the internal test set and 40 cases in an external test set. RESULTS: Based on testing with the three-dimensional maxillofacial data from the 200-case internal test set, the MDGR-Net model achieved an R² value of 0.91 for the rotation matrix and 0.98 for the translation matrix. The average angle error on the internal and external test sets were 0.84°±0.55° and 0.58°±0.43°, respectively. The construction of the three-dimensional maxillofacial symmetry reference plane for 40 clinical cases took only 3 seconds, with the model performing optimally in the patients with skeletal Class Ⅲ malocclusion, high angle cases, and Angle Class Ⅲ orthodontic patients. CONCLUSION This study proposed the MDGR-Net association method based on intelligent point cloud registration as a novel solution for constructing three-dimensional maxillofacial symmetry reference planes in clinical dental applications, which can significantly enhance diagnostic and therapeutic efficiency and outcomes, while reduce expert dependence.
Humans ; Deep Learning ; Algorithms ; Imaging, Three-Dimensional/methods* ; Male ; Female ; Maxilla/diagnostic imaging* ; Adult

Purpose: The risk stratification of pediatric anaplastic large cell lymphoma (ALCL) has not been standardized. In this study, new risk factors were included to establish a new risk stratification system for ALCL, and its feasibility in clinical practice was explored. Materials and Methods: On the basis of the non-Hodgkin’s lymphoma Berlin–Frankfurt–Munster 95 (NHL-BFM-95) protocol, patients with minimal disseminated disease (MDD), high-risk tumor site (multiple bone, skin, liver, and lung involvement), and small cell/lymphohistiocytic (SC/LH) pathological subtype were enrolled in risk stratification. Patients were treated with a modified NHL-BFM-95 protocol combined with an anaplastic lymphoma kinase inhibitor or vinblastine (VBL). Results: A total of 136 patients were enrolled in this study. The median age was 8.8 years. The 3-year event-free survival (EFS) and overall survival of the entire cohort were 77.7% (95% confidence interval [CI], 69.0% to 83.9%) and 92.3% (95% CI, 86.1% to 95.8%), respectively. The 3-year EFS rates of low-risk group (R1), intermediate-risk group (R2), and high-risk group (R3) patients were 100%, 89.5% (95% CI, 76.5% to 95.5%), and 67.9% (95% CI, 55.4% to 77.6%), respectively. The prognosis of patients with MDD (+), stage IV cancer, SC/LH lymphoma, and high-risk sites was poor, and the 3-year EFS rates were 45.3% (95% CI, 68.6% to 19.0%), 65.7% (95% CI, 47.6% to 78.9%), 55.7% (95% CI, 26.2% to 77.5%), and 70.7% (95% CI, 48.6% to 84.6%), respectively. At the end of follow-up, one of the five patients who received maintenance therapy with VBL relapsed, and seven patients receiving anaplastic lymphoma kinase inhibitor maintenance therapy did not experience relapse. Conclusion This study has confirmed the poor prognostic of MDD (+), high-risk site and SC/LH, but patients with SC/LH lymphoma and MDD (+) at diagnosis still need to receive better treatment (ClinicalTrials.gov number, NCT03971305).

Objective:To compare the short-term clinical effect of gastrointestinal or enterointestinal dominant channels after radical proximal gastrectomy combined with dual-channel anastomosis for upper gastric cancer.Methods:A total of 72 patients in Hefei Second People's Hospital from Jan 2017 to Jul 2021 were retrospectively analyzed, including 29 patients in the total gastrectomy group, and 43 patients in the group of radical proximal gastrectomy+dual-channel anastomosis, and by imaging results it was futher stratified into gastrointestinal dominant channel sub-group (26 cases) and intestinal dominant channel sub-group (17 cases).Results:The number of lymph node dissection in the total gastrectomy group was more than that in the proximal stomach group (27.9±3.2 vs. 25.4±2.9, t=3.441, P<0.05). While the 12 months post operation albumin [(36.1±2.4) g/L vs. (34.1 ± 2.3) g/L, t=3.526, P=0.001], hemoglobin [(122.9 ± 6.9) g/L vs. (115.9 ± 6.0) g/L, t=4.444, P=0.000], vitamin B12 [(349.0±21.7) pmol/ml vs. (77.9±8.5) pmol/ml, t=63.931, P=0.000] level, and the body mass index [(23.01±0.78) kg/m 2vs. (21.95±0.67) kg/m 2, t=5.978, P=0.000] decline level was unfavored ( P<0.05). The 12 months post operation vitamin B12 level, body mass index, albumin and hemoglobin level had no statistical difference in the two subgroups of proximal gastrectomy (all P>0.05). Conclusions:Laparoscopic proximal gastrectomy with double tract reconstruction for proximal gastric cancer is safe and reliable, which can effectively improve the postoperative nutritional status, prevent postoperative anemia.

Objective: To understand the influence of experiential health education on diet control of college students with pre diabetes mellitus, and to provide reference for healthy eating habits promotion among college students. Methods: According to the method of random number table, 78 pre diabetic college students screened from Changzhi Medical College from September 2020 to June 2021 were randomly assigned to observation group and control group (39 students in each group). The control group received routine health education for 10 months, once a week for 1 hour each time; On the basis of the above, the observation group received experiential health education once a week for 1 hour, including diet experience, exercise experience, blood sugar test experience and chronic complications experience. Blood glucose and lipids level, body mass index (BMI), dietary control as well as the stages of change for dietary control behavior were compared between the two groups. Results: There was significant difference between the observation group and the control group in the stages of change for dietary control behavior 10 months after intervention ( χ 2=8.92, P <0.05). The compliance score of the observation group was significantly higher than that of the control group in the same period 10 months after the intervention ( t =3.74, P <0.01), the score of the knowledge of diet control in the observation group 10 months after intervention was significantly higher than that in the control group ( t =11.51, P <0.05). The levels of BMI, TG and TC in the observation group were significantly lower than those in the control group at 5 and 10 months after intervention, and the differences were statistically significant ( P <0.05). Conclusion Experiential health education helps to promote awareness of diabete related knowledge, enhance self management behavior and good diet control habits, and is effective for blood glucose control.

Strengthening the supervision of medical insurance funds is an important measure to promote the healthy and sustainable development of the medical security system. In January 2022, a tertiary general hospital in Beijing carried out risk identification and prevention and control practices for the use of medical insurance funds. By using such methods as fault tree analysis and risk matrix, the probability and impact of events were quantitatively evaluated, high-risk events during the use of medical insurance funds were identified, and corresponding risk prevention and control measures were developed, relying on intelligent regulatory systems. From January to November 2022, the hospital outpatient medical insurance refusal amount(20 080 yuan) caused by such high-risk events as exceeding drug instructions, exceeding medical insurance indications, and exceeding age limits decreased by 42.30% compared to the same period in 2021(11 585 yuan). The discharge and settlement time of medical insurance patients decreased from 3 working days to 1 working day. This practice had effectively improved the quality and efficiency of hospital medical insurance fund supervision, improved patients′ medical experience, and provided reference for strengthening the safe and standardized use of medical insurance funds by medical institutions.

OBJECTIVES: Liver cancer is the sixth most common malignant tumor in the world. Hepatocellular carcinoma (HCC) accounts for 85%-90% of all patients with liver cancer. It possesses the characteristics of insidious onset, rapid progression, early recurrence, easy drug resistance, and poor prognosis. NIMA related kinase 2 (NEK2) is a cell cycle regulating kinases, which regulates cell cycle in mitosis. Cellular senescence is a complex heterogeneous process, and is a stable form of cell cycle arrest that limits the proliferative potential of cells. This study aims to investigate the relationship between the expression level of NEK2 and the senescence in hepatoma cells, and to explore the effect of NEK2 expression on hepatoma cell senescence and the underlying molecular mechanism. METHODS: A total of 581 senescence-relevant genes were obtained from the GenAge website. The gene expression data of tumor tissues of 370 HCC patients were downloaded from the Cancer Genome Atlas database. The co-expression of NEK2 and aging-related genes was analyzed by R-package. KEGG was used to analyze the significant gene enrichment pathway of differentially expressed genes in NEK2 overexpression HEK293. The stable transfected cell lines with overexpression and knockdown of NEK2 were constructed in hepatoma cell line SMMC-7721 and HepG2, and senescence-associated β-galactosidase (SA-β-gal) staining was used to detect senescence, the cell proliferation was detected by CCK-8 method and clone formation experiment, the cell cycle was analyzed by flow cytometry, and the expression of proteins related to p53/p21, p16/Rb, and phosphatase and tensin homolog deleted on chromosome ten (PTEN)/Akt signal transduction pathway was detected by Western blotting. RESULTS: There were 320 senescence related genes co-expressed with NEK2. KEGG analysis showed that the senescence signaling pathway was significantly enriched in HEK293 cells with overexpression of NEK2.Compared with SMMC-7721 or HepG2 without knockdown of NEK2, the senescent cells of SMMC-7721 and HepG2 with knockdown of NEK2 were increased, cell proliferation and clone formation were decreased significantly, the percentage of cells in G₀/G₁ phase was increased, the expression levels of phospho-Akt (p-Akt) and phospho-Rb (p-Rb) protein were decreased significantly, and the expression level of p16 protein was increased significantly (all P<0.05). Compared with SMMC-7721 or HepG2 transfected with blank plasmid, the senescent cells of SMMC-7721 and HepG2 overexpressing NEK2 were decreased, the cell proliferation and clone formation were increased significantly, the percentage of cells in G₀/G₁ phase were decreased, the expression levels of p-Akt and p-Rb protein were increased significantly, and the expression level of p16 protein was decreased significantly (all P<0.05). CONCLUSIONS NEK2 may mediate the anti-aging effect of hepatoma cells through p16/Rb and PTEN/Akt signal transduction pathways, which provides a new theoretical basis for NEK2 to promote the progress of liver cancer and a new idea for the targeting treatment for liver cancer.
Carcinoma, Hepatocellular/pathology* ; Cell Line, Tumor ; Cell Proliferation/physiology* ; Cellular Senescence/genetics* ; HEK293 Cells ; Humans ; Liver Neoplasms/pathology* ; NIMA-Related Kinases/genetics* ; Proto-Oncogene Proteins c-akt/metabolism*

Objective:To explore the types of venous access, indwelling time and the correlation with catheter-related bloodstream infection (CRBSI) of very and extremely low birth weight infants (VLBW & ELBW) in NICU.Methods:The self-designed venous access data collection form was used to collect the venous access data of VLBW & ELBW infants who were admitted to NICU of Children′s Hospital of Fudan University from January to December 2019. SPSS 22.0 software was used for data analysis, description and binary Logistic regression analysis.Results:A total of 218 cases were collected, including 9 cases of peripheral intravenous (PIV), 30 cases of PIV+ umbilical vein catheter (UVC), 43 cases of PIV+PICC, 136 cases of PIV+UVC+PICC. The average indwelling time of UVC was 6 days, the average indwelling time of PICC was 22 days. There were 23 cases (10.55%) got CRBSI and 195 cases (89.45%) without CRBSI. Binary Logistic regression analysis showed that birth weight ( OR=1.003, 95% CI 1.000-1.006, P<0.05) and combination form of venous access ( OR=0.139, 95% CI 0.023-0.834, P<0.05) of VLBW & ELBW infants were associated with CRBSI. Conclusions:In NICU, PIV, UVC and PICC are the three main ways to indwell venous access for VLBW & ELBW infants. The occurrence of CRBSI is closely related to the type and combination of indwelling venous access.