AIM: To investigate the preoperative ocular symptoms and the characteristics of asymptomatic ocular surface abnormalities in hospitalized patients with primary pterygium.METHODS: Cross-sectional study. Hospitalized patients diagnosed with primary pterygium and scheduled to receive pterygium excision surgery at the Xiamen Eye Center of Xiamen University from August 2022 to October 2022 were enrolled. Ocular surface disease index questionnaire(OSDI), six examinations including non-invasive tear film break-up time, Schirmer I test, tear meniscus height, lid margin abnormality, meibomian gland dropout and tear film lipid layer thickness, and anterior segment optical coherence tomography(AS-OCT)were performed and statistically analyzed.RESULTS: A total of 178 cases(178 eyes), with a mean age of 54.39±10.75 years old, were recruited, including 75 males(42.1%)and 103 females(57.9%). The average values of ocular surface parameters in these patients included OSDI: 11.47±9.69, tear film break-up time: 7.10±3.86 s; tear meniscus height: 0.16±0.07 mm, Schirmer I test values: 14.39±7.29 mm/5 min, and pterygium thickness: 504.74±175.87 μm. Totally 161 eyes(90.4%)presented with abnormal lid margin, 44 eyes(24.7%)presented with meibomian gland dropout score ≥4, 52 eyes(29.2%)presented with low lipid layer thickness. In the 6 objective examinations, abnormalities in at least 4 of these tests were found in 85.4% of eyes. Pterygium morphology was classified into four grades: 10 eyes(5.6%)of grade Ⅰ, 93 eyes(52.2%)of grade Ⅱ, 60 eyes(33.7%)of grade Ⅲ, and 15 eyes(8.4%)of grade Ⅳ. In patients with a higher grade of pterygium, the tear film break-up time was lower, and the proportion of abnormal lid margin was also significantly higher(P<0.05). The patients were further divided into two subgroups, including 121 eyes(68.0%)with normal OSDI <13 in the normal group and 57 eyes(32.0%)with OSDI ≥13 in the abnormal group. No significant difference was found in the proportion of meibomian gland dysfunction between the two groups of patients(71.9% vs. 71.9%, P=0.872). In addition, there were differences in the number of abnormal objective examinations(4.11±0.85 vs. 4.91±0.99, P<0.001).CONCLUSIONS: Asymptomatic ocular surface abnormalities were present preoperatively in patients hospitalized for primary pterygium. A comparable high incidence of structural or functional meibomian gland dysfunction existed in pterygium patients with or without apparent ocular discomfort. More attention should be paid to the ocular surface abnormalities in those asymptomatic patients before primary pterygium surgery.

Objective? To explore the application effect of self-help lower limb functional exercise shoes in elderly patients after total knee arthroplasty(TKA). Methods? A total of 58 patients with knee osteoarthritis who underwent TKA in the Second Affiliated Hospital of Wenzhou Medical University from September of 2017 to September 2018 were selected and randomly divided into the control group(n=28) and observation group(n=30). Routine functional exercise method was adopted in the control group while self-help lower limb functional exercise shoes were applied in the observation group. The time needed to master the functional exercise instruction, compliance with the functional exercise and knee joints activity post-operation in the two groups were compared. Results? The time needed to master the functional exercise instruction in the observation group was (4.3±1.5)min, shorter than the control group with statistical significance (t=4.87, P＜ 0.01). In the observation group there were 27 patients who had high compliance with the functional exercise, while 15 patients in the control group had high compliance, the difference was statistically significant (χ2=9.62,P＜0.05). Three months after operation, the knee joint activity of the observation group was better than that of the control group (115.3±11.3)°, the difference was statistically significant (t=2.45, P＜0.05). Conclusions? The use of self-help lower limb functional exercise can help the elderly TKA patients to master the functional exercise method faster, improve their compliance with postoperative functional exercise, improve postoperative rehabilitation exercise effects and promote early recovery of the affected limb functional.

Aiming at the new problems in orthodontics teaching and employment,this study aims to explore a more suitable undergraduate teaching mode of Orthodontics,and reform the teaching of Orthodontics for five-year program students in department of stomatology of Xi'an Medical University.During the teaching of Orthodontics,teachers use the aesthetic principles that students have learned to integrate into the orthodontics teaching,and guide students to analyze,understand and master orthodontic knowledge based on the principles of aesthetics.After the course,students give good feedback on the teaching reform,and their scores of basic knowledge and case analysis of Orthodontics theoretical examination have been improved.This teaching reform is very helpful for students to learn,understand and master the knowledge of orthodontics.It helps to improve classroom teaching effect,improve students' interest in learning,and adapt to the needs of discipline and industry development,so it is worth studying and promoting.

Objective To explore the effects and mechanism of electroacupuncture (EA) on denervation-induced atrophy in rats. Methods A total of 18 male Sprague-Dawley rats were divided into sham group (n=6), model group (n=6) and EA group (n=6). The latter two groups were clamped right sciatic nerve to establish atrophy model of skeletal muscle. On the second day after modeling, EA group accepted electroacupuncture on right Zusanli (ST36) and Huantiao (GB30) for two weeks. Their gastrocnemius muscles were obtained after intervention, and the wet weight ratio of the gastrocnemius muscles was calculated. The cross-sectional area (CSA) and diameter of muscle fibers were measured after HE staining. The protein expression of mammalian target of rapamycin (mTOR), phosphorylated mTOR (p-mTOR), 70-KD ribosomal protein S6 kinase (p70S6K) and phosphorylated p70S6k (p-p70S6k) was tested with Western blotting. The gene expression of mTOR and p70S6K was detected with real-time quantitative polymerase chain reaction. Results Compared with the sham group, the wet weight ratio of the gastrocnemius muscle, CSA and diameter of the muscle fibers decreased in the model group and EA group (P<0.001), which were more in EA group than in the model group (P<0.01); the protein expression of mTOR, p-mTOR, p70S6K and p-p70S6K increased in the model group (P<0.01), and increased more in EA group (P<0.05); the gene expression of mTOR and p70S6K increased in the model group (P<0.05) , and increased more in EA group (P<0.05).Conclusion Electroacupuncture delays the atrophy of denervated skeletal muscles, which may relate to activation of mTOR/p70S6K signal pathway to impact synthesis of skeletal muscle proteins.

Objective To investigate the epidemiology characteristics of crawfish related rhabdomyolysis (RM) in Nanjing, 2016.Methods Outpatient and inpatient electronic medical system of 21 hospitals in Nanjing during 2016 were retrospectively searched, and all the patients diagnosed with RM were selected. The patients with none crayfish-related RM was excluded. The epidemiology characteristics were depicted. The geographic information system (GIS) was used to collect, manage and analyze the spatial data, to visualize it, to analyze the spatial distribution features of the disease, and to explore the cause of disease prediction. GeoDa 1.8 software was used to analyze the global and local spatial auto-correlation.Results A total of 1183 patients with crawfish related RM were initially screened, excluding 59 patients with RM caused by trauma, severe exercise, heat stroke, myositis, poisoning, drugs, and genetic diseases, and 1124 patients were enrolled. The proportion of men was 36.48% (410/1124) with an incidence of 12.54/100 thousands; while of women was 63.52% (714/1124) with an incidence of 21.86/100 thousands. The median age at onset was 34 (28, 43) years. From July to August, the incidence of crawfish related RM was the highest, accounting for 96.53% of the total number of cases. The top four incidence areas were Pukou (41.54/100 thousands), Jianye (25.94/100 thousands), Qixia (25.73/100 thousands), Gulou (25.04/100 thousands), all of which were adjacent to the Yangtze River. Global spatial autocorrelation analysis showed: MoranI = 0.427,Z = 2.646,P = 0.003, suggesting that the crawfish related RM had positive spatial autocorrelation. The results showed that the spatial structure of crawfish related RM existed in Nanjing in 2016. Local spatial autocorrelation analysis showed that the high-high concentration areas were Pukou, Jianye and Liuhe. The incidences of above three areas which were the Nanjing section of the lower reaches of the Yangtze River flowed through the region and surrounding areas were higher than the overall incidence of Nanjing.Conclusion The prevalence of crawfish related RM in Nanjing during 2016 had an obvious region-concentrated character and global spatial autocorrelation with the high prevalent regions mainly concentrated in the urban areas adjacent to the Yangtze River.

Objective:To evaluate the effect of pinus massoniana bark extract (PMBE) and grape seed extract (GSE) on dentin demineralization caused by acid.Methods:40 root dentin blocks with half of the surface covered were randondy divided into 4 groups (n =10).All samples were subjected to pH cycling for 8 days,and deionized distilled water(DDW),0.1％NaF,12％ PMBE solution and 12％ GSE solution were used as the experimental solutions in the 4 groups.The dentin mineral density(DMD) of the both sides was determined using micro-computed tomography.The D-value of DMD between nn-demineralized and demineralized side (△DMD)was calculated.The samples were observed with field emission scanning electron microscops (FE-SEM).Results:The △DMD of DDW,NaF,PMBE and GSE groups was 198.64 ±59.97,45.94 ±24.21,90.23 ±28.77 and 105.07 ±29.53 respectively.The △DMD between PMBE and GSE groups had no significant difference (P ＞ 0.05),which were both higher than that of NaF group (P ＜ 0.05) and lower than that of DDW group(P ＜ 0.05).The FE-SEM revealed that the dentin tubules in DDW group were completely open,but in NaF group were essentially closed in PMBE group and GSE group were spindle shaped or narrow crack opening.Conclusion:PMBE and GSE had almost the same effect on improving the acid resistance of dentin.

Objective To explore the risk factors of postoperative activities of daily living in elderly patients after hip fracture. Methods By convenience sampling,from October 2013 to June 2015,150 elderly patients having undergone surgery after hip fracture were selected,with data of 141 cases finally collected. Gender,age,underlying diseases,surgical procedures,postoperative complications,ambulation time,whether walking with aids,family caregivers and reexamination conditions were recorded for evaluation of the patients about their activities of daily living half a year after the surgery. Mean comparison and chi-square test were used for univariate analysis about the above factors and Logistic regression analysis was used to identify possible risk factors. Results It was shown in univariate analysis that recovery of postoperative activities of daily living was influenced by age,surgical procedures,postoperative complications,ambulation time,walking aids,etc. (P< 0.05);it was shown in multivariate logistic regression that age (OR=1.065,95%CI:1.010-1.124, P=0.020),surgical procedures (OR=2.900,95%CI:1.200-7.008,P=0.018),postoperative complications (OR=6.366,95%CI:2.592-15.632,P< 0.001),ambulation time (OR=2.684,95%CI:1.133-6.359,P=0.025) and walking aids (OR=5.796,95%CI:1.542-21.780,P=0.009) were risk factors of postoperative daily living ability in elderly patients after hip fracture. Conclusions Old age,developing internal fixation surgery after incision,postoperative complications, walking more than 3 months after operation or walking without aids affect postoperative activities of daily living in elderly patients after hip fracture,thus affecting their quality of life, which makes it necessary for nursing staff to focus on risk factors for positive prevention and intervention.

OBJECTIVEThis study aims to evaluate the effects of Pinus massoniana needle extract (PMNE) on inhibiting demineralization of root dentin.

METHODSRoot dentin blocks were randomly divided into distilled deionized water (DDW) group, fluoride sodium (NaF) group, and 4%, 8% and 12% PMNE groups according to the experimental solution used in the process of pH cycling in each group. All specimens in each group experienced pH cycling for 8 d. The dentin mineral density (DMD) of the normal dentin and demineralized dentin and their D-value (ΔDMD) were determined using micro computed tomography. The morphology of dentin surface after pH cycling was also observed using a scanning electron microscope.

RESULTSThe ΔDMD values in all PMNE groups and the NaF group were considerably lower than the ΔDMD in the DDW group (P<0.05). The ΔDMD values of the 8% and 12% PMNE groups had no difference (P>0.05), both of which were lower than the ΔDMD in the 4% PMNE group and higher than that in the NaF group (P<0.05). The dentin tubules were partly opened in the PMNE groups. The opening degrees of the dentin tubule in PMNE groups were significantly less and smaller than the opening degree in the DDW group and were larger than that in the NaF group.

CONCLUSIONSPMNE can inhibit the deminera-lization of root dentin and can slow down the reduction in DMD. PMNE has the potential to prevent caries, and 8% PMNE can effectively inhibit dentin demineralization.

Objective To establish the method of isolation,culture and identify biological characterization of mesenchymal stem cells from human umbilical cord (hUCMSCs);and study their multiple differentiation potency.Methods Stem cells from human umbilical cord were cultured by enzyme Wharton jelly method in vitro.The surface markers were identified by flow cytometry.Multi-differentiation capacity was identified by osteogenic and adipogenic differentiation.ALP was detected with Calcium cobalt staining.The mineralized ability in vitro was measured with Alizarin red staining.Theadipocyte differen-tiation ability was measured with oil red-O staining.Results Flow cytometry analysis revealed that CD73 (92.45%),CD90 (95.45%)and CD105 (96.45%)were highly expressed on these cells’surface,while CD34 (1.07%)were negative ex-pressed.Cells were cultured with induced-osteogenic medium after 3 weeks,ALP staining in the cytoplasm of black parti-cles,and a large amount of mineralized nodules within cells was observed after 4 weeks.Cells were cultured with induced-adi-pogenic medium after 2 weeks,the majority of these cells were round,oil red O staining of lipid droplets generated within cells was observed.Conclusion Mesenchymal stem cells from human umbilical cord have the potential of multi-directional differentiation.These cells could be induced to differentiate into adipocytes and osteoblasts,which laid the foundation for clinical stem cell therapy research source of seed cells.

Objective To investigate the effects of local application of insulin like growth factor-1 (IGF-1) absorbable gelatin sponge complex in implant fossa on osseointegration around implant in osteoporosis rats.Methods Female SD rats,aged 4 months,were randomly individed into ovariectomy group (OVX group) and sham-ovariectomy group (sham-ovx group).The rats in OVX group (n=15) were ovariectomized,and the rats in Sham-OVX group (n=10) underwent Sham-ovariectomy.Eight weeks later,5 rats in each group were randomly selected to confirm the osteoporosis model.The ovariectomized rats were randomly divided into osteoporosis group (OP group) and IGF-1 group after the model was successfully established,5 rats in each group.Pure titanium implants were implanted in the distal part of right femoral epiphyseal in all groups.Absorbable gelatin sponge particles containing 10 μg IGF-1 were placed in the planting fossa in the IGF-1 group,and absorbable gelatin sponge particles without IGF-1 were used in OP group and sham-OVX group.The rats were sacrificed,and then the distal part of right and left femoral epiphyses were taken out to make undecalcified and decalcified tissue sections respectively after 8 weeks.Combined bone lamelta width (CBLW) and implant bone contact rate (IBCR) around implant,trabecular width (TW) and trabecular area percentage (TA) around implant and in the cortical bone of left femoral epiphyses were observed by histomorphometric measurement.Results The CBLW,IBCR,TW and TA around implant was(55.43±3.50)μm,(81.79±4.45) ％,(57.73 ±4.29) μtm and (62.21 ±7.42) ％ respectively in sham-OVX group,(60.22±4.70)μm,(83.67 ±6.63)％,(48.08 ±3.63) μtm and (58.20±8.93) ％ respectively in IGF-1 group,and (37.11 ±2.18) μtm,(64.60±5.44)％,(41.19 ±2.93) μm and (42.21±4.34) ％ respectively in OP group.The CBLW,IBCR and TW around implant had no differences between IGF-1 and sham-OVX group (P ＞ 0.05),which were significantly higher than those in OP group(P ＜ 0.05).The TW and TA of cortical bone in left distal femoral epiphyses was (60.85 ±6.64) μtm,(61.24 ±6.98) ％ respectively in shamOVX group,(38.68 ±4.74) μtm,(43.89 ±7.76) ％ respectively IGF-1 group,(40.46±5.38) μtm,(44.63±5.39) ％ respectively in OP group (P ＜ 0.05).The TW and TA of cortical bone in left distal femoral epiphyses had no differences between IGF-1 group and OP group (P ＞ 0.05),which were all significantly lower than those in sham-OVX group (P ＜ 0.05).Conclusions The local application of IGF-1 gelatin sponge complex can increase bone tissue around implant and improve osseointegration in osteoporosis.