Objective To analyze the influencing factors of cardiac valve calcification(CVC)in elderly patients with diabetic nephropathy undergoing maintenance hemodialysis and to construct and validate a nomogram prediction model.Methods A total of 280 elderly patients with diabetic ne-phropathy undergoing maintenance hemodialysis were selected as study subjects and divided into CVC group and non-CVC group based on the occurrence of CVC.Clinical data of the two groups were com-pared.The least absolute shrinkage and selection operator(LASSO)-Logistic regression analysis was used to screen the influencing factors of CVC occurrence in patients.A nomogram prediction model was constructed based on these factors and its predictive performance was validated.Results Among 280 patients,91 developed CVC,with an incidence rate of 32.50％.Patients in the CVC group had higher age,dialysis vintage,proportion of secondary hyperparathyroidism,proportion of valvular insufficiency,proportion of left ventricular hypertrophy,systolic blood pressure,calcium-phosphorus product,and serum levels of fibroblast growth factor 23(FGF23),soluble growth stimulation expressed gene 2protein(sST2),retinol-binding protein(RBP),and pentraxin 3(PTX3)compared to the non-CVC group.In contrast,low-density lipoprotein and Klotho levels were lower in the CVC group(P＜0.05).LASSO-Logistic regression analysis revealed that age,secondary hyperparathyroidism,calcium-phosphorus product,and serum levels of FGF23,Klotho,sST2,RBP,and PTX3 were in-dependent influencing factors for CVC occurrence in elderly patients with diabetic nephropathy undergoing maintenance hemodialysis(P＜0.05).A nomogram prediction model was constructed based on these independent influencing factors.The receiver operating characteristic(ROC)curve and calibration curve demonstrated that the model had good discrimination,accuracy,and predictive performance.Conclusion Age,secondary hyperparathyroidism,calcium-phosphorus product,and serum levels of FGF23,Klotho,sST2,RBP,and PTX3 are independent influencing factors for CVC occurrence in elderly patients with diabetic nephropathy undergoing maintenance hemodialysis.The nomogram prediction model constructed based on these factors exhibits high discrimination,accura-cy,and predictive performance.

A cemental tear is defined as an incomplete or complete detachment of the cementum along the dentino-cemental junction(CDJ)or the incremental line within the body of the cementum,which can also involve part of the root dentine adjacent to the cementum.The pathogenesis of cemental tears is not fully elucidated.From the literature review,possible predisposing factors were identified,including tooth type,sex,age,periodontitis,previous periodontal treatment or root canal treatment,history of dental trauma,and occlusal trauma or excessive occlusal force.The morphology of ce-mental tears can be either piece-shaped or U-shaped,which usually contributes to periodontal and periapical break-down.Clinically,cemental tears have a unitary periodontal pocket and present with symptoms mimicking localized peri-odontitis,apical periodontitis,and vertical root fractures.Imaging examination is of great significance for the clinical di-agnosis of cemental tears,which often manifest as thin'prickle-like'radiopaque masses located longitudinally adjacent to the affected root surface.Exploratory surgery is needed in some cases.Although intraoperative cemental fragments and cemental lines on the root surface can assist in the diagnostic process,histopathology examination is the gold stan-dard for the diagnosis of cemental tears.The treatment methods vary depending on the timing of the correct diagnosis and the clinical or radiological manifestations.With the development of regenerative biomaterials and the development of intentional replantation,an increasing number of affected teeth can survive for a long time.The aim of this review is to systematically describe the biological basis and predisposing factors,clinical features,radiographic and histological characteristics,diagnosis and clinical management of cemental tears,and treatment outcomes to help make a clear di-agnosis and develop a personalized treatment plan.

Objective To investigate the effect of Cyclocarya paliurus(Batal.)lljinskaja polysaccharides on insulin resistance in type 2 diabetic rats by regulating glucose transporter 4(GLUT4)translocation in islet and liver.Methods High-fat diet combined with low-dose streptozotocin(35 mg·kg-1)to induce type 2 diabetes model,all the rats were randomly divided into model control group,Cyclocarya paliurus polysaccharides groups(5,10 g·kg-1)and metformin group(0.25 g·kg-1),and treated for eight weeks(n=9 in each group).Fasting glucose and lipid were determined.Histopathology of rat islet and liver were observed by hematoxylin and eosin staining.Protein expressions of phosphorylated phosphoinositide-3-kinase(p-PI3K),phosphorylated serine-threonine kinase 1(p-Akt1),and GLUT4 in islet were measured by immunohistochemistry staining.GLUT4 translocation in the islet and liver was detected by immunofluorescence.Results Compared with the model control group,the Cyclocarya paliurus polysaccharides group and metformin group had declined fasting glucose levels and increased high-density lipoprotein(P＜0.05).The structure of the islets and liver was relatively complete.The content of p-PI3K,p-Akt1 and GLUT4 in the islet increased(P＜0.05).GLUT4 translocation in the liver and islet enhanced(P＜0.05).Conclusions Cyclocarya paliurus polysaccharides alleviate glucose and lipid metabolism disorders.The mechanism may lay in it activating protein expressions of p-PI3K,p-Akt1,and GLUT4 in islet cells.GLUT4 translocation to the islet and liver cell membrane are increased to regulate peripheral islet resistance.

Objective:To optimize the detection method for residual solvents of esmolol hydrochloride for control of internal quality.Methods:Gas chromatography headspace injection method was adopted by selecting appropriate headspace equilibrium temperature and time in order to reduce sample contamination of the instrument,optimizing solvent ratio for reducing matrix effect and adjusting carrier gas flow rate and split ratio.Polar capillary column pro-grammed temperature rise method was used with high temperature holding time,etc.,and methodological validation was conducted.Results:Ether,ethyl acetate,methanol,and toluene could all be effectively separated with good precision,and there were good linear relationships between peak areas and mass concentrations.The accuracy of sample spiking at 50％,100％,and 150％concentrations was investigated,and the average recovery rates could all reach ranges of 94.8％-105.6％.Conclusion:This method is accurate,highly sensitive,and overcomes the shortcomings of the Chinese Pharmacopoeia methods.It can be used for the detection of residual solvents in esmolol hydrochloride.

Objective To investigate the prevalence and molecular features of Cryptosporidium in captive-bred Mustela putorius furo in Jiangsu Province.. Methods A total of 290 fresh stool samples were collected from a ferret farm in Jiangsu Province on May 2017, and the small subunit rRNA (SSU rRNA) gene of Cryptosporidium was amplified in stool samples using nested PCR assay. The actin, cowp and gp60 genes were amplified in positive samples and sequenced to characterize Cryptosporidium species/genotypes. Results A total of 18 stool samples were tested positive for Cryptosporidium SSU rRNA gene, with a detection rate of 6.2%. Sequence and phylogenetic analyses of SSU rRNA, actin and cowp genes characterized Cryptosporidium isolated from captive-bred ferrets as Cryptosporidium sp. ferret genotype. In addition, gp60 gene was amplified in 10 out of 18 stool samples tested positive for Cryptosporidium. Conclusions Cryptosporidium is widely prevalent in captive-bred ferrets in Jiangsu Province, and Cryptosporidium sp. ferret genotype is the only Cryptosporidium genotype in ferrets.

Objective:To investigate an accurate and quantitative method to measure the eyeball morphological parameters of guinea pigs through a method that combines programmed digital techniques and mathematical geometric principles.Methods:Twenty-two three-week-old clean-grade male tricolor guinea pigs were selected and sacrificed by anesthesia overdose.Eyeballs were enucleated.The horizontal and sagittal images of the eyeball were taken with the high-speed photographic model of 13 million pixels macro meter, and the pictures were imported into pycharm programming software.Using the pre-written analysis program of Python 3.9, the conversion coefficient between the photo pixel and the actual length was obtained by a scale, and then the corneal surface was fitted by arc fitting and conic curve fitting.The results of arc fitting were converted to calculate the corneal radius of curvature.The corneal eccentricity was calculated according to the general conic equation (Ax 2+ Bxy+ Cy 2+ Dx+ Ey+ F=0). The corneal asphericity was evaluated by curve fitting between the central 3-mm and the whole cornea.The use and care of the animals complied with Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.The study protocol was approved by the Ethics Committee of Shanghai Public Health Clinical Center (No.2022-A009-01). Results:The digital method of Python programming can show the corneal contour of guinea pigs completely and clearly.In the transverse plane, there was no significant difference in the corneal curvature measurements among the digital fitting in central 3-mm cornea, digital fitting in whole cornea and curvature meter ( F=1.693, P=0.190). In the sagittal plane, there was a significant difference in the corneal curvature measurements among the three methods ( F=3.500, P=0.030), and the corneal curvature measurements of the whole cornea measured by the curvature meter were significantly greater than those measured by the digital fitting ( P<0.05). There was no statistical significance in the measurements of corneal curvature radius among the three methods in the transverse plane and the sagittal plane ( F=1.817, P=0.170; F=2.050, P=0.133). The horizontal and sagittal corneal eccentricity measured by digital fitting in central 3-mm cornea were 0.55±0.15 and 0.53±0.17, which were lower than 0.66±0.10 and 0.64±0.14 measured by digital fitting in whole cornea, and the differences were statistically significant ( t=-4.860, -5.210; both at P<0.01). Conclusions:It is feasible to use Python programming digital method to measure the corneal curvature and eccentricity of guinea pigs.

CCAAT enhancer binding protein β (C/EBPβ), as a nuclear transcription factor necessary for the development of liver, airway epithelium, and adipose tissue, plays a vital role in physiological processes related to cell proliferation, apoptosis, and differentiation. However, the up-regulation of C/EBPβ activates signal pathways related to inflammatory response, epithelial-mesenchymal transition, cell proliferation and invasion, immune response, and angiogenesis by regulating a series of downstream genes transcription promotes the development of lung diseases. Therefore, targeting C/EBPβ may be a potential treatment strategy for lung diseases. This paper summarizes the regulatory effects of C/EBPβ and related signaling pathways in lung infection, asthma, chronic obstructive pulmonary disease, lung injury, pulmonary fibrosis, and lung cancer to provide a theoretical basis for the precision medicine of lung diseases.

Objective To study the effect of scenario case based learning for nurse-patient communicationon empathy of un-dergraduate nursing students. Methods The undergraduate nursing students who had completed the basic nursing courses and the course of"communication in nursing"were enrolled as participants.Seventy-two students recruited in 2013 were assigned as the control group,where only individual guidance was given before taking examination;while eighty-nine students recruited in 2014 as the inter-vention group,where a self-compiled Collection of Scenarios for Nurse-Patient Communication was given when they were preparing for the final examination and the students were required to give their own communication plans based on the scenario cases from the collec-tion.The two groups were compared in view of empathy. Result The intervention group were better in empathy ability assessment, with statistically significant difference (P<0.001). Conclusions The scenario case based learning for nurse-patient communication makes up for the shortcomings of traditional teaching methods.It encourages nursing students to think from the patients'perspective and improves the empathy ability of students.

Objective To retrospectively analyse the anaesthetic management of Norwood Stage Ⅰ.Methods Between June 2010 and August 2014, totally 5 small infants with HLHS underwent the standard Norwood Stage I procedure .They were all boys.Age at surgeries ranged from 29 to 75 days with median 36 days, and weight from 2.57 -3.50 kg with median of 3.13kg.The first three cases were received intravenous prostaglandin E1 before they were sent to the operation theatre and were under mechanical ventilation .They were received emergent operations because of unstable hemodynamic situation .The other two cases were relatively stable without mechanical ventilation and were received restrict surgery .All 5 cases received the stand-ard Norwood Stage Ⅰprocedure under intravenous-inhalation balance-general anaesthesia with cardiopulmonary bypass.The technique of deep hypothermia and circulatory arrest were used in all five cases .Results The fourth case died from low cardi-ac output syndrome after cardiopulmonary bypass .The other 4 cases were transferred to the paediatric intensive care unit after withdrawal from bypass.One of the four cases died after 32 h after surgery.Conclusion The standard Norwood Stage Ⅰ pro-cedure is aquite complex procedure, which demands multidisplinary cooperation, to palliatively correct HLHS.We retrospect the experiences of the anesthetic management in our centre and hope it will be helpful to decrease the mortality and morbidity in relatively short period.