Objective:The DNA aptamers of lipoprotein-associated phospholipase A2 (Lp-PLA2), a marker of vasculitis, were screened and a visual detection method using unlabeled nucleic acid aptamer-gold nanoparticle (AuNP) probe was established.Method:Lp-PLA2 aptamers were screened through 8 cycles of incubation binding, ssDNA isolation, PCR amplification and single strand recovery by the magnetic bead fixation SELEX technique. The affinity and specificity of the aptamers were validated using surface plasmon resonance technology and flow cytometry, and the secondary structure of the aptamer and its three-dimensional molecular docking with the target protein were simulated by computer software. Subsequently, aptamer-AuNP complex was prepared, and the color change was caused by salt-induced condensation of the AuNP solution by target competitive binding. Then, the target concentration was detected by measuring the absorbance of the solution with a spectrophotometer. The linear relationship between the sample absorbance and concentration of Lp-PLA2 were established under the optimal determine conditions.Results:Three Lp-PLA2 aptamers B76-2, B76-4 and B76-5 with high affinity and strong specificity were obtained, and the dissociation constants were 1.07, 1.26 and 1.75 nmol/L, respectively. Then AuNP colorimetric sensing method based on B76-2 aptamer was successfully constructed. The linear range and detection limit of Lp-PLA2 were 20-500 ng/ml and 78 ng/ml, respectively, and the reaction time was 30 min, which could specifically distinguish the target from other thrombotic markers such as thrombin and myeloperoxidase.Conclusion:A simple, rapid and specific visual detection method for visually detecting Lp-PLA2 was established by using aptamer-AuNP colorimetric assay.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Objective To investigate the predictive value of labor progress angle (AOP), fetal head descent distance (HPD) and their change rates in the outcome of vaginal trial of cesarean scar uterus. Methods A total of 170 pregnant women who underwent vaginal trial production of scar uterus after cesarean section were selected as study subjects, and were divided into successful group and failed group based on the trial production outcomes. Advanced oxidation processes (AOP) and head-perineum distance (HPD) were measured by ultrasound during the active phase of the first stage of labor when the cervix dilated to 4 cm and at 1 hour after the cervix dilated to 4 cm, respectively. The AOP change rate and HPD change rate after 1 hour of progress were calculated. The receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of AOP, HPD and their change rates in the outcome of vaginal trial production of scar uterus after cesarean section. Delong test was used to compare the differences in area under curves (AUCs). Results Among 170 pregnant women with scarred uterus after cesarean section who were pregnant again, 139 cases (success group) were succeed in transvaginal delivery, while 31 cases failed trial delivery, and transferred to cesarean section (failure group). The AOP of the successful group was significantly larger than that of the failed group when the cervix was opened to 4 cm, and the HPD was significantly shorter than that of the failure group (P < 0.05). The AOP change rate and the change rate of HPD of the successful group were significantly higher than that of the failed group when the cervix dilated to 4 cm and at 1 hour (P < 0.05). The AUC of AOP and HPD in predicting the outcome of vaginal trial delivery of scar uterus after cesarean section were 0.846 and 0.812 respectively, and AUC predicted jointly by AOP and HPD showed no significant differences compared with AUC predicted separately (P>0.05). The AUC of the change rate of AOP and HPD in predicting the outcome of vaginal trial delivery of scarred uterus after cesarean section was 0.899 and 0.852 respectively, and the combined prediction of AOP change rate and HPD change rate had a higher AUC value than the AUC predicted separately. Its AUC value was higher than that of AOP combined with HPD (P < 0.05). Conclusion The AOP, HPD and their change rates when the uterine orifice expands to 4 cm in the active phase of the first stage of labor have predictive value for the outcome of vaginal trial production of scarred uterus after cesarean section.

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.

[摘 要] 目的：探讨卵巢癌组织中PD-L1与唾液酸结合性免疫球蛋白样凝集素15（Siglec-15）的关系及其临床意义以及两者对卵巢癌SKOV3细胞增殖、迁移及侵袭的影响。方法：收集2017年1月至2019年12月福建医科大学附属第二医院妇科50例手术切除的卵巢癌组织和配对输卵管组织的石蜡包埋标本，采用免疫组化染色Envision法检测癌组织和输卵管组织中PD-L1和Siglec-15的表达水平，Kaplan-Meier生存曲线和Logistic回归分析PD-L1和Siglec-15表达与患者预后的关系。利用瞬时转染技术在卵巢癌细胞SKOV3中分别转染si-PD-L1和si-NC，用qPCR和WB法检测SKOV3细胞中PD-L1的表达对Siglec-15的影响，用CCK-8及Transwell法验证PD-L1及Siglec-15表达对SKOV3细胞增殖、迁移及侵袭的影响。结果：50例卵巢癌组织中，PD-L1与Siglec-15均呈高表达（50.00%与42.00%）。PD-L1表达与肿瘤病理类型、有无腹水、淋巴结转移、FIGO分期及卵巢癌复发与否具有关联（均P<0.05）；Siglec-15表达与卵巢癌患者淋巴结转移及FIGO分期具有关联（均P<0.05）。成功构建PD-L1低表达SKOV3细胞株，降低PD-L1表达可使Siglec-15表达升高。结论：PD-L1和Siglec-15在卵巢癌组织中均有较高的阳性表达率，PD-L1是卵巢癌复发的独立风险因素。PD-L1和Siglec-15两者的表达呈负相关，降低PD-L1表达可使Siglec-15表达水平升高而抑制SKOV3细胞增殖、迁移和侵袭的能力。

[摘 要] 目的：探讨甲状腺滤泡癌（FTC）组织中程序性死亡蛋白1（PD-1）和NOD样受体蛋白3（NLRP3）的表达及其与患者临床病理特征和预后的关系。方法：收集2015年1月至2020年6月福建医科大学附属第二医院手术切除的60例FTC患者的癌和配对癌旁组织标本，采用免疫组织化学染色法检测癌及癌旁组织中PD-1和NLRP3的阳性表达率，χ²检验或者Fisher精确检验法分析PD-1和NLRP3表达与FTC患者临床病理特征的关系，Pearson相关性分析PD-1与NLRP3表达的关系，Kaplan-Meier生存和Logistic回归分析PD-1和NLRP3表达与患者预后的关系。结果：在60例FTC组织中，PD-1和NLRP3均有较高的阳性表达率（46.67%与63.33%）。PD-1表达与FTC患者肿瘤分期、肿瘤大小、血管侵犯、复发与否具有显著相关性（均P<0.05），NLRP3表达与患者肿瘤大小、血管侵犯、甲状腺外浸润以及复发具有显著相关性（均P<0.05）。PD-1与NLRP3的表达成负相关，前者与患者更好的预后相关，后者是FTC复发的独立风险因素。结论：PD-1和NLRP3在FTC组织中有较高的阳性表达率，前者与患者更好的预后相关，后者是FTC复发的独立风险因素，且两者的表达呈负相关。

Objective : To investigate the incidence of dental anxiety in pregnant women and its influencing factors. Methods : A total of 2 638 pregnant women in Shanghai were included in this study. Data on demographic and social factors, oral health behaviors and the number of teeth were collected. Participants completed the modified dental anxiety scale (MDAS), and an MDAS score greater than 12 was defined as a dental anxiety disorder. An electronic data capture system (EDC) was used to establish a database, and SPSS 22.0 was used to analyze the degree of anxiety and its influencing factors. Results: A total of 2 638 valid questionnaires were received. The incidence of dental anxiety in pregnant women was 34.9%. The results of a univariate analysis showed that the prevalence of dental anxiety in pregnant women (P<0.001) and MDAS score decreased (P<0.05) with increasing age, annual family income, educational level, frequency of cleaning, frequency of brushing and number of teeth. Conversely, the prevalence of dental anxiety in pregnant women (P<0.05) and MDAS score increased (P<0.05) as the number of pregnancies and gingival bleeding increased. Logistic analysis showed that education level “college” (P = 0.003) and “bachelor and above” (P<0.001), frequency of dental cleaning “semiannually or annually” (P = 0.021) and “biennial” (P<0.001), and frequency of brushing “twice a day” (P<0.001) were significantly associated with dental anxiety in pregnant women and were protective factors (OR<1). The frequency of gingival bleeding “Sometimes”(P<0.001) and the number of teeth “≤ 27” (P<0.001) were also significant risk factors for dental anxiety in pregnant women (OR>1).The results of a negative binomial regression analysis of MDAS showed that the frequency of dental cleaning and the number of teeth were significantly associated with dental anxiety. The frequency of dental cleaning "semiannually or annually" (P<0.001) was a protective factor (OR<1) for pregnant women's dental anxiety. The number of teeth ≤27 (P<0.001) was a risk factor (OR>1) for dental anxiety in pregnant women. Conclusion Educational level, teeth cleaning frequency, teeth brushing frequency, gingival bleeding, and the number of teeth influence dental anxiety in pregnant women. To effectively reduce the prevalence of dental anxiety, dentists should attach great importance to it in clinical practice and enhance pregnant women's awareness of oral hygiene maintenance by disseminating relevant health care knowledge.

[摘 要] 目的： 探讨程序性死亡蛋白-配体1（programmed death ligand-1，PD-L1）和肿瘤浸润淋巴细胞（tumor-infiltrating lymphocyte, TIL）在三阴性乳腺癌（triple-negative breast cancer，TNBC）组织中的水平及其临床意义。方法：收集2015年1月至2019年1月福建医科大学附属第二医院手术切除的61例TNBC患者的癌及癌旁组织石蜡标本，用免疫组化法检测癌组织中PD-L1表达和CD8+ TIL的水平，用卡方检测方法分析TNBC组织中PD-L1和CD8+ TIL水平与患者临床病理特征及预后的关系。结果： PD-L1和CD8+ TIL在TNBC组织中的阳性率分别为63.9%（39/61）和32.8%（20/61）。PD-L1表达与TNBC患者的肿瘤大小、淋巴结转移、病理分期、复发与否有明显关联（均P<0.05），与患者的年龄、肿瘤分化程度、脉管侵犯以及Ki67表达水平无明显关联（均P>0.05）；CD8+ TIL水平与TNBC患者的肿瘤大小、肿瘤分化程度、淋巴结转移、病理分期、复发与否有明显关联（均P<0.05），与患者的年龄、脉管侵犯以及Ki67表达水平无明显关联（均P>0.05）。PD-L1和CD8+ TIL水平与患者的无进展生存期（PFS）及总生存期（OS）具有显著相关性（均P<0.05），PD-L1+或者缺乏CD8+ TIL与患者更差的PFS及OS相关（均P<0.05）。结论：TNBC组织中存在较高水平的PD-L1和CD8+ TIL，PD-L1阳性表达或缺乏CD8+ TIL与肿瘤侵袭性增加相关，也与患者更差的PFS及OS相关。

[Abstract] Objective: To detect the expression of zinc transporter 1 (ZnT1) gene in glioma tissue, and to explore its effect on the proliferation, migration and invasion of U87 cells. Methods: From October 2015 to January 2017, 20 patients with glioma, who received no chemoradiotherapy before operation, were collected from Department of Neurosurgery, the First Affiliated Hospital of China Medical University. The protein and mRNA content of ZnT1 in glioma tissues and adjacent tissues were detected by Western blotting and Realtime PCR, respectively. ZnT1 and si-ZnT1 plasmids were transfected into glioma U87 cell line respectively to construct ZnT1 over-expression U87 cell line and ZnT1 knockdown U87 cell line. The effects of ZnT1 on proliferation, migration and invasion of U87 cells were detected by MTT and transwell assay. Results: Both mRNA and protein expressions of ZnT1 in glioma tissues was significantly higher than those in adjacent tissues (all P<0.05). U87 cell lines with ZnT1 over-expression and knockdown were successfully constructed. Compared with the control group and empty plasmid control group, the proliferation (0.54±0.01 vs 0.45±0.04, 0.43±0.03, P<0.01), invasion and migration (all P<0.05) of U87 cells with ZnT1 over-expression were significantly increased at 12 h after transfection; however, the proliferation (0.37±0.03 vs 0.45±0.01, 0.44±0.03, P<0.01), invasion and migration (all P<0.05) of U87 cells with ZnT1 knockdown were decreased significantly. Conclusion: ZnT1 was highly expressed in glioma tissues, and promoted the proliferation, migration and invasion of glioma U87 cells.

OBJECTIVE:To investigate clinical efficacy and safety of conjugeted estrogen tablets combined with Salmon calci-tonin acetate injection and Alendronate sodium tablets in the treatment of osteoporosis in postmenopausal. METHODS:148 post-menopausal women with osteoporosis were randomly divided into observation group(78 cases)and control group(70 cases). Con-trol group was given Salmon calcitonin acetate injection hypodermically or intramuscularly,100 IU each time,once a day in first week,every two days in second week,every three days in third week,21 times of consecutive injection as a treatment course;Alendronate sodium tablet,70 mg each time,once a week,3 months as a treatment course. Based on control group,observation group was additionally given conjugeted estrogen tablets,0.625 mg each time,qd,for consecutive 3 weeks,drug withdrawal for one week,and then continued to taking drug,for 3 months in total. Clinical efficacy of 2 groups were observed as well as BGP, bone metabolism index as human collagen type Ⅰ N-terminal peptide (NTX) and ALP,bone density and ADR before and after treatment. RESULTS:After treatment,total effective rate of observation group was 94.87%,which was significantly higher than 78.57% in control group,with statistical significance(P<0.05);BGP,lumbar spine and thigh-bone density of 2 groups were all improved significantly,and the improvement of observation group was more significant than that of control group,with statistical significance (P<0.05). NTX and ALP of 2 groups were decreased significantly,and the decrease of observation group was more significant than that of control group,with statistical significance (P<0.05). The incidence of ADR was 12.82% in observation group and 8.57% in control group,without statistical significance (P>0.05);various ADR disappeared after drug withdrawal. CONCLUSIONS:Conjugeted estrogen tablets combined with Salmon calcitonin acetate injection and Alendronate sodium tablets can effectively relieve bone pain,regulate bone metabolism,increase bone density and induce slight ADR in postmenopausal with osteoporosis.