Background::Histological healing is closely associated with improved long-term clinical outcomes and lowered relapses in patients with ulcerative colitis (UC). Here, we developed a novel diagnostic criterion for assessing histological healing in UC patients.Methods::We conducted a retrospective cohort study in UC patients, whose treatment was iteratively optimized to achieve mucosal healing at Shanghai Tenth People’s Hospital of Tongji University from January 2017 to May 2022. We identified an inflammatory cell enumeration index (ICEI) for assessing histological healing based on the proportions of eosinophils, CD177 + neutrophils, and CD40L + T cells in the colonic lamina propria under high power field (HPF), and the outcomes (risks of symptomatic relapses) of achieving histological remission vs. persistent histological inflammation using Kaplan-Meier curves. Intrareader reliability and inter-reader reliability were evaluated by each reader. The relationships to the changes in the Nancy index and the Geboes score were also assessed for responsiveness. The ICEI was further validated in a new cohort of UC patients from other nine university hospitals. Results::We developed an ICEI for clinical diagnosis of histological healing, i.e., Y = 1.701X 1 + 0.758X 2 + 1.347X 3 - 7.745 (X 1, X 2, and X 3 represent the proportions of CD177 + neutrophils, eosinophils, and CD40L + T cells, respectively, in the colonic lamina propria under HPF). The receiver operating characteristics curve (ROC) analysis revealed that Y <-0.391 was the cutoff value for the diagnosis of histological healing and that an area under the curve (AUC) was 0.942 (95% confidence interval [CI]: 0.905-0.979) with a sensitivity of 92.5% and a specificity of 83.6% ( P <0.001). The intraclass correlation coefficient (ICC) for the intrareader reliability was 0.855 (95% CI: 0.781-0.909), and ICEI had good inter-reader reliability of 0.832 (95% CI: 0.748-0.894). During an 18-month follow-up, patients with histological healing had a substantially better outcome compared with those with unachieved histological healing ( P <0.001) using ICEI. During a 12-month follow-up from other nine hospitals, patients with histological healing also had a lower risk of relapse than patients with unachieved histological healing. Conclusions::ICEI can be used to predict histological healing and identify patients with a risk of relapse 12 months and 18 months after clinical therapy. Therefore, ICEI provides a promising, simplified approach to monitor histological healing and to predict the prognosis of UC.Registration::Chinese Clinical Trial Registry, No. ChiCTR2300077792.

ObjectiveTo evaluate the caries prevention effect of different fluoride application frequencies in 3-year-old children with active caries. MethodsA total of 337 3-year-old children with dental caries from 12 kindergartens in Changning District of Shanghai were divided into three groups： group 1 received fluoride application once every three months， group 2 received fluoride application once every six months， and the control group received no fluoride application. At baseline， parents completed a questionnaire survey， and oral examinations were conducted at baseline， 7 months， and 16 months after the fluoride intervention to assess the incidence of new dental caries， new dmft， and new dmfs of children. Multivariate logistic regression analysis was used to analyze the relationship between fluoride application and new dental caries， with new dental caries as the dependent variable and local fluoride application， child's gender， age in months， parents' highest education level， frequency of sugary intake （desserts， candies， sweet beverages）， age of toothbrushing initiation， frequency of daily toothbrushing， use of fluoride toothpaste， parental assistance in child’s toothbrushing， and daily use of dental floss as the independent variables. ResultsThere were no significant differences in baseline general conditions and oral health behaviors among group 1 （121 cases）， group 2 （123 cases） and the control group （93 cases） （all P>0.05）. After 16 months' intervention， three children were lost to follow-up due to transferring schools. The new caries rates of group 1 （120 cases）， group 2 （121 cases） and the control group （93 cases） were 5.83%， 24.79% and 52.69%， respectively. The incidence of new caries was significantly lower in group 1 compared to group 2 and the control group （P<0.001）， and it was also significantly lower in group 2 compared to the control group （P<0.001）. The newly-increased caries of group 1， group 2 and the non-fluoride control group were all 0.12 0.52， 0.36 0.68 and 1.16 1.39， respectively. The mean increment of new caries was lower in group 1 compared to group 2 （P=0.040） and the non-fluoride control group （P<0.001）， and it was lower in group 2 compared to the non-fluoride control group （P<0.001）. After adjusting for factors such as gender， parents' education level and child's oral health behaviors by multivariate logistic regression， the results showed that fluoride application once every three months could significantly reduce the risk of dental caries （OR=0.04， P<0.001）. ConclusionLocal use of fluoride has a certain effect on the prevention and treatment of dental caries in children with active caries. Fluoride application once every three months effectively reduces the incidence of new caries and slows down the progression of caries lesions. It is suggested that local application of fluoride should be implemented once every three months for children with active caries.

Objective To explore the therapeutic effects of comprehensive hyperbaric oxygen therapy (HBO) on cerebral hemorrhage patients in vegetative state (VS) and influential factors on the prognosis of cerebral hemorrhage.Methods Seventy-five cerebral hemorrhage patients who were admitted into the Department of Hyperbaric Oxygen,Beijing Chaoyang Hospital and conformed to the criteria of vegetative state were enrolled for the study.All the patients received 3 to 6 courses of comprehensive HBO therapy and completed 6-month medical follow-ups.Then,improvement of cognition was evaluated before comprehensive HBO therapy,at the 3-month and 6-month medical follow-ups respectively by using the Coma Recovery Scale-Revised (CRS-R).Results At the 3-month and 6-month medical follow-ups,the CRS-R scores were considerably improved as compared with those before treatment,and statistical significance could be seen when comparisons were made between the groups (P ＜ 0.01).At the 6-month follow-up,22 patients regained consciousness,accounting for (29.3％),and 53 patients still had conscious disorder,accounting for 70.7％.With regard to age,gender,causes of cerebral hemorrhage,sites of cerebral hemorrhage,ventricular hemorrhage and courses of HBO therapy,no statistical significance could be noticed in the patients who recovered consciousness at the 6-month medical follow-up,when compared with those who still had conscious disorder(P ＞0.05).As compared with those who had conscious disorder,the CRS-R scores of the patients in the conscious recovery group before treatment were higher.HBO At the 6-month follow-up,the conscious recovery rate of the patients with the amount of hemorrhage equal or lower than 45 ml (40.5％) was obviously higher than that of the patients with the amount of hemorrhage higher than 45 ml (18.4％),and statistical significance could be noted when comparisons were made between them (P ＜ 0.05 or P ＜ 0.01).Logistic regression analysis indicated that the amount of hemorrhage (＞ 45 ml/≤45 ml,OR =8.944,P =0.049),the time of comprehensive HBO therapy (OR =1.182,P =0.006),the CRS-R scores before treatment (OR =0.040,P =0.000) were related with the prognosis of the patients.Conclusion In the treatment of cerebral hemorrhage patients in vegetative state,the amount of hemorrhage,the time of comprehensive HBO therapy and the CRS-R scores before treatment were all influential factors that affected the prognosis of the patients.For this reason,comprehensive HBO therapy should be administered as early as possible.

Objective To explore the therapeutic effects of comprehensive hyperbaric oxygen therapy (HBO) on cerebral hemorrhage patients in vegetative state (VS) and influential factors on the prognosis of cerebral hemorrhage.Methods Seventy-five cerebral hemorrhage patients who were admitted into the Department of Hyperbaric Oxygen,Beijing Chaoyang Hospital and conformed to the criteria of vegetative state were enrolled for the study.All the patients received 3 to 6 courses of comprehensive HBO therapy and completed 6-month medical follow-ups.Then,improvement of cognition was evaluated before comprehensive HBO therapy,at the 3-month and 6-month medical follow-ups respectively by using the Coma Recovery Scale-Revised (CRS-R).Results At the 3-month and 6-month medical follow-ups,the CRS-R scores were considerably improved as compared with those before treatment,and statistical significance could be seen when comparisons were made between the groups (P ＜ 0.01).At the 6-month follow-up,22 patients regained consciousness,accounting for (29.3％),and 53 patients still had conscious disorder,accounting for 70.7％.With regard to age,gender,causes of cerebral hemorrhage,sites of cerebral hemorrhage,ventricular hemorrhage and courses of HBO therapy,no statistical significance could be noticed in the patients who recovered consciousness at the 6-month medical follow-up,when compared with those who still had conscious disorder(P ＞0.05).As compared with those who had conscious disorder,the CRS-R scores of the patients in the conscious recovery group before treatment were higher.HBO At the 6-month follow-up,the conscious recovery rate of the patients with the amount of hemorrhage equal or lower than 45 ml (40.5％) was obviously higher than that of the patients with the amount of hemorrhage higher than 45 ml (18.4％),and statistical significance could be noted when comparisons were made between them (P ＜ 0.05 or P ＜ 0.01).Logistic regression analysis indicated that the amount of hemorrhage (＞ 45 ml/≤45 ml,OR =8.944,P =0.049),the time of comprehensive HBO therapy (OR =1.182,P =0.006),the CRS-R scores before treatment (OR =0.040,P =0.000) were related with the prognosis of the patients.Conclusion In the treatment of cerebral hemorrhage patients in vegetative state,the amount of hemorrhage,the time of comprehensive HBO therapy and the CRS-R scores before treatment were all influential factors that affected the prognosis of the patients.For this reason,comprehensive HBO therapy should be administered as early as possible.

Objective To detect the change and clinical significance of homocysteine (Hcy),hypersensitivity C response protein (hs-CRP) and hypersensitivity troponin I (hs-TnI) in patients with acute myocardial infarction (AMI).Methods Ninety-six cases of AMI were selected as the research group and 60 cases of coronary heart disease without AMI were enrolled in the control group.Blood samples were collected to measure the contents of serum Hcy,hs-CRP and hs-TnI.ROC curve was drawn and Logistic regression model was established to analyze the role of each index alone and combined detection in the diagnosis of AMI.Results The levels of Hcy,hs-CRP and hs-TnI in the research group were significantly higher than those in the control group (Hcy: (29.29±7.65) mol/L vs.(17.23±4.68) mol/L;hs-CRP: (15.47±5.01) mg/L vs.(9.21±3.15) mg/L;hs-TnI: (40.88±9.18) ng/mL vs.(7.34±2.12) ng/mL,t=2.78,8.66,34.36,P<0.05).The area under the ROC curve of Hcy,hs-CRP,hs-TnI were 0.802 (95%CI(0.729~0.874)),0.71(95%CI(0.62~0.792)),0.929 (95%CI(0.891~0.967)),respectively.The area under the combine detection curve was 0.971 (95%CI,0.950~0.992).The sensitivity of Hcy,hs-CRP and hs-TnI in the diagnosis of AMI were 79%,57%,87%,respectively,the specificity of the three groups were 72%,70%,90%,the sensitivity and specificity of combined detection were 96% and 88%.Conclusion Combined detection of Hcy,hs-CRP and hs-TnI plays a better role in the diagnosis of AMI than that of Hcy,hs-CRP,hs-TnI alone and has a high specificity and sensitivity in the diagnosis of AMI.

Objective To investigate the effects of hyperbaric oxygen (HBO)combined with herbal "scorpion seven" on the expression levels of stromal cell-derived factor-1/chemokine receptor-4 (SDF1/ CXCR4) in the plasma of the patients with acute spinal cord injury (ASCI).Methods Sixty patients with acute incomplete spinal cord injury were chosen for the study,and were divided into the control group (n =30)which was treated with conventional drug therapy plus HBO and the treatment group (n =30) which received herbal " scorpion seven" treatment in addition to conventional drug therapy plus HBO therapy.Close observations were made on expression levels of SDF1/CXCR4 receptors in plasma at the same time points before therapy,and at day 10,day 30,day 60 and day 90.Results As compared with those of the patients of the control group,the expression levels of SDF1/CXCR4 and VEGF in the plasma of the patients with ASCI were significantly increased,at day 10,day 30,day 60 and day 90 after treatment,and statistical significance could be seen when comparisons were made between the 2 groups (P ＜0.05).Peak value appeared at day 10,and the expression levels of SDF1/CXCR4 and VEGF at day 90 after treatment were still higher than the baseline of initial injury.Conclusions HBO combined with herbal "scorpion seven" could promote the recovery of vascular endothelial function in the patients with ASCI through the access of increasing the levels of SDF1/ CXCR4 and VEGF in peripheral blood.

Objective To observe changes in hepatic microcirculation perfusion after acute carbon monoxide poisoning and effects of hyperbaric oxygen (HBO) on hepatic microcirculation by using laser Doppler blood perfusion imager.Methods Ninety Wistar rats were randomly divided into 9 groups:the control group,the CO exposure group which was subdivided into the CO exposure day 1,3,7 and 12 groups (or the CO day 1 group,the CO day 3 group,the CO day 7 group and the CO day 12 group),the CO exposure + HBO group which was subdivided into CO exposure + HBO therapy day 1,3,7 and 12 groups (or the HBO day 1 group,HBO day 3 group,HBO day 7 group and HBO day 12 group).Levels of hepatic and intestinal mucosa microcirculation perfusion were detected by using laser blood perfusion imager.Results In the control group,the CO day 1 group and the HBO day 1 group,the level of hepatic microcirculation perfusion was significantly lower than that of intestinal mucosa microcirculation perfusion.Statistical significance could be seen when comparisons were made between them (P ＜ 0.05),however,changes of the two were identical.The level of hepatic microcirculation perfusion in the CO day 1 group was obviously increased,as compared with those of the HBO day 1,3,7 and 12 groups(P ＜0.05).However,there was no statistical significance when comparisons were made between the CO day 12 group and the HBO day 12 group(P ＞ 0.05).Conclusions Laser Doppler blood perfusion imager could detect changes in the level of hepatic microcirculation perfusion.Acute carbon monoxide poisoning could obviously decrease the level of hepatic microcirculation perfusion,but HBO treatment could help to improve hepatic microcirculation disturbance.

Objective To investigate the effects of hyperbaric oxygen (HBO)combined with herbal "scorpion seven" on the expression levels of stromal cell-derived factor-1/chemokine receptor-4 (SDF1/ CXCR4) in the plasma of the patients with acute spinal cord injury (ASCI).Methods Sixty patients with acute incomplete spinal cord injury were chosen for the study,and were divided into the control group (n =30)which was treated with conventional drug therapy plus HBO and the treatment group (n =30) which received herbal " scorpion seven" treatment in addition to conventional drug therapy plus HBO therapy.Close observations were made on expression levels of SDF1/CXCR4 receptors in plasma at the same time points before therapy,and at day 10,day 30,day 60 and day 90.Results As compared with those of the patients of the control group,the expression levels of SDF1/CXCR4 and VEGF in the plasma of the patients with ASCI were significantly increased,at day 10,day 30,day 60 and day 90 after treatment,and statistical significance could be seen when comparisons were made between the 2 groups (P ＜0.05).Peak value appeared at day 10,and the expression levels of SDF1/CXCR4 and VEGF at day 90 after treatment were still higher than the baseline of initial injury.Conclusions HBO combined with herbal "scorpion seven" could promote the recovery of vascular endothelial function in the patients with ASCI through the access of increasing the levels of SDF1/ CXCR4 and VEGF in peripheral blood.

Objective To observe changes in hepatic microcirculation perfusion after acute carbon monoxide poisoning and effects of hyperbaric oxygen (HBO) on hepatic microcirculation by using laser Doppler blood perfusion imager.Methods Ninety Wistar rats were randomly divided into 9 groups:the control group,the CO exposure group which was subdivided into the CO exposure day 1,3,7 and 12 groups (or the CO day 1 group,the CO day 3 group,the CO day 7 group and the CO day 12 group),the CO exposure + HBO group which was subdivided into CO exposure + HBO therapy day 1,3,7 and 12 groups (or the HBO day 1 group,HBO day 3 group,HBO day 7 group and HBO day 12 group).Levels of hepatic and intestinal mucosa microcirculation perfusion were detected by using laser blood perfusion imager.Results In the control group,the CO day 1 group and the HBO day 1 group,the level of hepatic microcirculation perfusion was significantly lower than that of intestinal mucosa microcirculation perfusion.Statistical significance could be seen when comparisons were made between them (P ＜ 0.05),however,changes of the two were identical.The level of hepatic microcirculation perfusion in the CO day 1 group was obviously increased,as compared with those of the HBO day 1,3,7 and 12 groups(P ＜0.05).However,there was no statistical significance when comparisons were made between the CO day 12 group and the HBO day 12 group(P ＞ 0.05).Conclusions Laser Doppler blood perfusion imager could detect changes in the level of hepatic microcirculation perfusion.Acute carbon monoxide poisoning could obviously decrease the level of hepatic microcirculation perfusion,but HBO treatment could help to improve hepatic microcirculation disturbance.

Objective To investigate the effects of hyperbaric oxygen (HBO) on endoplasmic reticulum stress(ERS) apoptosis after acute spinal cord injury (SCI) in rats,through detecting changes in the expressions of such related factor as ERS,and to further explore the mechanism of HBO biologically in the treatment of SCI.Methods The animals were randomly divided into 3 groups:the sham surgery group,the SCI group and the HBO group,each consisting of 24 rats.And each experimental group was further divided into 4 subgroups,in accordance with 1,3,7,and 14-day time-points after injury.the SCI animal model was established by using modified Allen's method,and HBO therapy was implemented accordingly.The motion of hinder limb was evaluated by using the Basso-Beattie-Bresnahan (BBB) score system at different time points after surgery.The injured spinal cord tissues were collected for TUNEL (TDT-mediated UTP nick-end labeling) for observation on the apoptosis of neural cells.The expressions of such ERS-related factors as glucose-regulated protein 78 (GRP78) and c-Jun NH2-terminal kinases (JNK) were detected by immunohistochemistry.The expression of caspases-3 was evaluated by enzyme-linked immunosorbent assay (ELISA).Results At day 7 and 14 after surgery,the BBB scores of the HBO group were significantly higher than those of the SCI group,and statistical significance could be noted,when comparisons were made between them(P ＜0.01).At day 3 and 7 after surgery,TUNEL positive cell rate of the HBO group was significantly higher than that of the SCI group,with statistical significance(P ＜0.05).At day 3 after surgery,the GRP78 positive cell counts of the HBO group were significantly higher than those of the SCI group,also with statistical significance(P ＜ 0.05).At day 3 and 7 after surgery,the JNK positive cell counts and the expression levels of caspase-3 of the HBO group were significantly lower than those of the SCI group,also with statistical significance(P ＜ 0.05,P ＜ 0.01).Conclusions The research results indicated that HBO therapy could elevate significantly the level of GRP78 following injury of the spinal cord,reduce the expression levels of JNK and caspase-3,alleviate ERS,decrease apoptosis of neural cells and enhance the scores of hinder limbs motor function of the SCI rats,thus promoting the recovery of the neurological function of the rats.