Objective:To evaluate the utility of pulse oximetry-derived parameters—specifically, the pulse oximetry plethysmographic waveform area under the curve (POP AUC) and the peripheral perfusion index (PPI)—in assessing disease severity and predicting prognosis in patients with sepsis. Methods:In this prospective descriptive study, 68 patients with sepsis were categorized based on illness severity into septic shock and non-shock groups, and by 28-day outcome into survival and non-survival groups. POP AUC, PPI, and lactate (Lac) levels were recorded at 0, 24, 48, 72, and 96 hours after admission. APACHEⅡ and SOFA scores were calculated within the first 24 hours. The prognostic value of these parameters was evaluated. Results:Significant differences were observed between the septic shock and non-shock groups in POP AUC, PPI, Lac (all P < 0.05 except at 96 h), APACHEⅡ, and SOFA scores (all P < 0.05). These differences were most pronounced at admission: POP AUC0 (2475.1 ± 899.0) vs. (4260.3 ± 1028.5), PPI 0 (0.78 ± 0.74) vs. (3.13 ± 2.18), Lac 0 (4.95 ± 4.32) vs. (2.07 ± 1.55), APACHE Ⅱ (16.78 ± 5.59) vs. 11.82 ± 4.89), and SOFA (8.89 ± 3.25) vs. (5.06 ± 2.60). Optimal prognostic cut-off values were 2741.43 for POP AUC, 0.97 for PPI, 2.05 for Lac, 12.5 for APACHEⅡ, and 5.5 for SOFA. ROC curve analysis showed that at 24 hours, POP AUC and PPI had significantly larger AUC values than Lac ( P < 0.05), while no significant differences were found among other parameters. Significant differences between non-survivors and survivors were also found in POP AUC, PPI (at 0, 24, and 48 h), APACHE II, and SOFA (all P < 0.05). No significant differences were observed in PPI (72 h and 96 h) or Lac between the two outcome groups. Conclusions:POP AUC and PPI, as derived from pulse oximetry, are non-inferior to Lac, SOFA, and APACHEⅡ scores in evaluating disease severity and predicting 28-day mortality in sepsis patients. These parameters show promise as practical and non-invasive tools for clinical assessment in sepsis.

Objective:To explore the application effects of the goal-oriented teaching method based on mind mapping in the teaching of stomatology practical courses.Methods:From September 2022 to September 2023, 52 fourth-year students of clinical stomatology at Harbin Medical University were divided into test group and control group for practical teaching, with 26 cases in each group. The test group received goal-oriented teaching based on mind mapping, while the control group received traditional teaching, for 20 class hours in both groups. The two groups were compared in terms of general data, theoretical and practical assessment scores, the score of the self-rating scale of self-directed learning (SRSSDL) and the score of critical thinking disposition inventory-Chinese version (CTDI-CV) before and after training, and student satisfaction with teaching activities. SPSS 25.0 software was used to perform the t-test or χ2 test. Results:After completing the practical training courses, the test group showed significantly higher scores than the control group in multiple-choice questions [(16.85±1.39) vs. (15.33±2.21)], fill-in-the-blank questions [(17.21±1.98) vs. (16.01±2.02)], short answer questions [(17.47±2.27) vs. (15.23±2.45)], case analysis [(34.36±2.79) vs. (32.57±3.02)], and practical assessment [(84.69±4.73) vs. (80.57±4.21)] (all P<0.05). The SRSSDL score and CTDI-CV score were improved in both groups, and were significantly higher in the test group [(215.29±10.42) and (357.49±17.80)] than in the control group [(200.23±11.42) and (342.23±17.26)] (both P<0.05). The students of the test group were significantly more satisfied with teaching activities than those of the control group ( P<0.05). Conclusions:Compared with the traditional teaching method, the goal-oriented teaching method based on mind mapping is more effective in stomatology practical teaching, which can improve students' self-directed learning ability and critical thinking ability, promote their mastery of theoretical knowledge, enhance their clinical practice ability, and increase their satisfaction with teaching activities.

This article reported a case of kaposiform lymphangiomatosis (KLA) identified in the fetal stage and diagnosed at the neonatal stage. A routine ultrasound examination at 19 weeks of gestation showed multiple masses in the whole body of the fetus (involving neck, chest wall and armpit) complicated by pleural and peritoneal effusion. Shunting was performed to drain pleural effusion from the right chest in another hospital at 26 +5 weeks of gestation. The patient was born at 34 +3 weeks of gestation by cesarean section due to "intrauterine distress" and required invasive ventilator assisted ventilation support after birth because of respiratory distress. A large amount of hemorrhagic effusion was drained out during the shunting. Coagulation dysfunction and thrombocytopenia occurred on the 3rd day after birth and KLA was suspected. Empirical treatment with sirolimus turned out to be ineffective. Biopsy was taken on postnatal day 7. However, the patient died on the 12th day after birth due to respiratory and circulatory failure. Pathological findings obtained the day after death were consistent with the features of KLA. The diagnosis of KLA was confirmed based on the clinical manifestations and pathological results.

Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect of bone-modifying agents and inhibits angiogenesis agents. Although the pathogenesis of MRONJ is not entirely clear, multiple factors may be involved in specific microenvironments. The TGF-β1 signalling pathway may have a key role in the development of MRONJ. According to the clinical stage, multiple variables should be considered when selecting the most appropriate treatment. Therefore, the prevention and management of treatment of MRONJ should be conducted in patient-centred multidisciplinary team collaborative networks with oncologists, dentists and dental specialists. This would comprise a closed responsibility treatment loop with all benefits directed to the patient. Thus, in the present review, we aimed to summarise the pathogenesis, risk factors, imaging features, clinical staging, therapeutic methods, prevention and treatment strategies associated with MRONJ, which may provide a reference that can inform preventive strategies and improve the quality of life for patients in the future.
Bisphosphonate-Associated Osteonecrosis of the Jaw/prevention & control* ; Bone Density Conservation Agents/adverse effects* ; Humans ; Quality of Life ; Risk Factors

Objective: To investigate the effects of zirconia micro coating on the proliferation and differentiation of osteoblasts on the surface of zirconia ceramic, and to provide a strategy for zirconia implant surface treatment. Methods: Forty tablets of zirconia ceramic, with the diameter of 15 mm and the thickness of 1.5 mm, were prepared. Then, twenty tablets polished by water sandpaper were taken as the control group, and 20 pieces of the zirconia coating after sintering micron were taken as the experimental group. The micromorphology of the surface of the two groups were observed by scanning electron microscope. The cell morphology after inoculation with MC3T3-E1 of osteoblasts on the surface of the material was investigated for 1, 3, and 5 days by scanning electron microscope. The cell proliferation was detected at 1 and 3 days by methyl thiazolyl tetrazolium. The cell differentiation ability was detected at 3 and 7 days by real-time quantitative PCR. Statistical analysis was conducted by independent sample t test. Results: After coating with zirconia micron particles, pores with the diameter of 1-20 μm could be observed on the surface of the test group of tiles through high temperature sintering. The growth of osteoblasts on the surface of the ceramic chip in the test group and control group exhibited the similar cell morphology. As they were cultured for 1 day, the experimental group exhibited a similar quality of cells as those in the test group (P>0.05). After 3 days' incubation, comparing with the cell quality of the test group (1.067 ± 0.077) (P<0.05), the quality of osteoblasts on the surface of zirconia ceramics coating increased to 1.763±0.165, and the expression of mRNA in alkaline phosphatase (ALP), osteopotin (OPN) and osteocalcin (OCN) also increased with the amount of 1.63±0.28, 1.99±0.41 and 1.60±0.30, respectively, compared with the test group (1.00± 0.00) (P<0.05). Seven days later, the expression of mRNA in Runt-related transcription factor-2 (RNUX2) (1.33±0.19), special AT-rich sequence binding protein-2 (SATB2) (1.64 ± 0.36), as well as alkaline phosphatase (ALP) (1.78±0.40), OPN (2.25±0.36), and OCN (1.88±0.21), showed a remarkably increase compared with the test group (1.00±0.00) (P<0.05). Conclusions Zirconia micro coating on the surface of zirconia ceramics promoted the proliferation and differentiation of osteoblasts adhered.

Aim To investigate the effects of 3 ,5 ,2 ’ , 4’-tetrahydroxychalcone (P40) on urate excretion, as well as mRNA and protein expressions of renal URAT1 and GLUT9 in hyperuricemic mice. Methods Sixty Kunming mice were randomly divided into six groups:normal control group, hyperuricemic group ( model group), P40 2. 0, 4. 0, 8. 0 mg·kg-1 groups and positive control group. All drugs were administered in-tragastrically to mice for 5 doses. Hyperuricemic mice were induced by intraperitoneal injection of uric acid (0. 15 g·kg-1 body weight) for 3 times. The urate levels were assayed with the phosphotungstic acid method. The mRNA and protein expressions of GLUT9 and URAT1 were determined by RT-PCR and Western blot. Results P40 at a dose of 4. 0 and 8. 0 mg · kg-1 significantly reduced the serum urate levels in a dose-dependent manner, when compared with untreat-ed hyperuricemic mice ( P<0. 05 or 0. 01 ) . The he-patic urate contents decreased in untreated-and treated-hyperuricemic mice as compared with normal mice ( P<0. 01 ) . Furthermore, P40 had no influence on the renal URAT1 mRNA and protein expression levels, while it could down-regulate renal GLUT9 protein ex-pression but not mRNA expression in hyperuricemic mice. Conclusion P40 possesses potent uricosuric effects associated with urate reabsorption by down-regu-lating the protein expression of GLUT9 in kidney.