Cardiovascular diseases that develop from hypercholesterolemia-induced atherosclerosis have emerged as a significant threat to human health.Recently,probiotics exhibiting cholesterol-lowering properties have emerged as a prominent area of research.Numerous studies have demonstrated that Lactobacillus reuteri can effectively reduce endogenous cholesterol synthesis,regulate cholesterol transport,and promote cholesterol degradation by modulating the expression of key genes,such as sterol-regulatory element binding protein 2,3-hydroxy-3-methyl-glutaryl coenzyme A reductase,and cholesterol 7 alpha-hydroxylase,in both the liver and intestinal epithelial cells of the host.This leads to a notable decrease in total cholesterol and low-density lipoprotein cholesterol levels in the host serum.The present paper offers a comprehensive overview of the underlying mechanisms responsible for the cholesterol-lowering effects exerted by L.reuteri,aiming to provide valuable insights into the treatment of hypercholesterolemia and the development of probiotics with cholesterol-lowering properties.

Cardiovascular diseases that develop from hypercholesterolemia-induced atherosclerosis have emerged as a significant threat to human health.Recently,probiotics exhibiting cholesterol-lowering properties have emerged as a prominent area of research.Numerous studies have demonstrated that Lactobacillus reuteri can effectively reduce endogenous cholesterol synthesis,regulate cholesterol transport,and promote cholesterol degradation by modulating the expression of key genes,such as sterol-regulatory element binding protein 2,3-hydroxy-3-methyl-glutaryl coenzyme A reductase,and cholesterol 7 alpha-hydroxylase,in both the liver and intestinal epithelial cells of the host.This leads to a notable decrease in total cholesterol and low-density lipoprotein cholesterol levels in the host serum.The present paper offers a comprehensive overview of the underlying mechanisms responsible for the cholesterol-lowering effects exerted by L.reuteri,aiming to provide valuable insights into the treatment of hypercholesterolemia and the development of probiotics with cholesterol-lowering properties.

Objective:To study the influence of surgical margins on the prognosis of anatomical hepatectomy in patients with hepatocellular carcinoma (HCC) based on a propensity score-matched (PSM) analysis.Methods:Clinical data of 200 patients with HCC undergoing anatomical hepatectomy at the Affiliated Cancer Hospital of Guangxi Medical University from December 2019 to December 2023 were retrospectively analyzed, including 169 males and 31 females, aged 53.4±12.0 years. Patients were divided into the narrow margin group (surgical margin ≤10 mm, n=133) and wide margin group (>10 mm, n=67) according to the width of the surgical margin. PSM was used to compare preoperative indicators such as the maximum diameter of the tumor, the integrity of the tumor capsule, sublesions, and the clinical stage of Barcelona liver cancer (BCLC), perioperative indicators such as intraoperative blood loss, and 24-hour postoperative laboratory indicators such as alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase between the two groups of patients. The prognosis was analyzed by the Kaplan-Meier method, and the postoperative recurrence-free survival rate of the two groups was compared by the log-rank test. Yates corrected chi-square test was used to analyze the postoperative liver function of the two groups of patients. Results:Before PSM, 133 cases were included in the narrow margin group and 67 cases in the wide margin group. There were statistically significant differences in the clinical stage of BCLC, intraoperative blood loss, alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase between the two groups (all P<0.05). After PSM, 55 cases were included in both the narrow margin group and the wide margin group. There were no statistically significant differences in the clinical stage, intraoperative blood loss, alanine aminotransferase and other indicators of BCLC between the two groups (all P>0.05). The 1-year, 2-year, and 3-year recurrence-free survival rates of the wide margin group were 94.2%, 80.1%, and 75.1% respectively, which were higher than those of the narrow margin group (71.8%, 52.9%, and 44.1%), the difference was statistically significant ( χ2=6.25, P=0.012). After PSM, a total of 12 patients (10.9%, 12/110) in the two groups developed liver dysfunction after the operation, among which 10 cases (18.2%, 10/55) were in the wide margin group and 2 cases (3.6%, 2/55). The incidence of postoperative liver dysfunction in the wide margin group was higher than that in the narrow margin group, the difference was statistically significant difference ( χ2=4.58, P=0.032). Conclusion:A surgical margin >10 mm can improve the relapse free survival rate, but it will increase the incidence of postoperative liver dysfunction.

Objective To analyze the characteristics of the crown-root ratios of the anterior teeth in subjects with different periodontal phenotypes in healthy population.Methods A total of 100 periodontally healthy young volunteers were selected,there were 53 females and 47 males,totaling 594 anterior teeth were included in the study.The periodontal probe method was used to determine the periodontal phenotypes of different tooth positions,with 108 cases of thick gingival type and 90 cases of thin gingival type in mesial incisors;95 teeth of thick gingival type and 103 teeth of thin gingival type in lateral incisors,and 98 teeth of thick gingival type and 100 teeth of thin gingival type in cuspids.Panoramic radiographs were taken,crown length and root length of upper anterior teeth were calculated,and crown-root ratio was calculated,to compare and analyze the differences between the results of the two groups.Results The crown-to-root ratio in thin gingival group of mesial incisors and lateral incisors were higher than those in thick gingival group,and the root length was smaller than thick gingival group.The difference was statistically significant(P＜0.05).The keratinized gingival width of thin gingival group was less than that of thick gingival group,and the difference was statistically significant(P＜0.05).Conclusion The relatively high crown-to-root ratio of mesial incisors and lateral incisors in patients with thin gingival phenotypes and the lesser width of keratinized gingiva in thin gingival phenotypes than thick gingival phenotypes.and risk assessment should be taken into account in the restorative system as well as in the orthodontic design of the anterior tooth movement.

Objective:To study the influence of surgical margins on the prognosis of anatomical hepatectomy in patients with hepatocellular carcinoma (HCC) based on a propensity score-matched (PSM) analysis.Methods:Clinical data of 200 patients with HCC undergoing anatomical hepatectomy at the Affiliated Cancer Hospital of Guangxi Medical University from December 2019 to December 2023 were retrospectively analyzed, including 169 males and 31 females, aged 53.4±12.0 years. Patients were divided into the narrow margin group (surgical margin ≤10 mm, n=133) and wide margin group (>10 mm, n=67) according to the width of the surgical margin. PSM was used to compare preoperative indicators such as the maximum diameter of the tumor, the integrity of the tumor capsule, sublesions, and the clinical stage of Barcelona liver cancer (BCLC), perioperative indicators such as intraoperative blood loss, and 24-hour postoperative laboratory indicators such as alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase between the two groups of patients. The prognosis was analyzed by the Kaplan-Meier method, and the postoperative recurrence-free survival rate of the two groups was compared by the log-rank test. Yates corrected chi-square test was used to analyze the postoperative liver function of the two groups of patients. Results:Before PSM, 133 cases were included in the narrow margin group and 67 cases in the wide margin group. There were statistically significant differences in the clinical stage of BCLC, intraoperative blood loss, alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase between the two groups (all P<0.05). After PSM, 55 cases were included in both the narrow margin group and the wide margin group. There were no statistically significant differences in the clinical stage, intraoperative blood loss, alanine aminotransferase and other indicators of BCLC between the two groups (all P>0.05). The 1-year, 2-year, and 3-year recurrence-free survival rates of the wide margin group were 94.2%, 80.1%, and 75.1% respectively, which were higher than those of the narrow margin group (71.8%, 52.9%, and 44.1%), the difference was statistically significant ( χ2=6.25, P=0.012). After PSM, a total of 12 patients (10.9%, 12/110) in the two groups developed liver dysfunction after the operation, among which 10 cases (18.2%, 10/55) were in the wide margin group and 2 cases (3.6%, 2/55). The incidence of postoperative liver dysfunction in the wide margin group was higher than that in the narrow margin group, the difference was statistically significant difference ( χ2=4.58, P=0.032). Conclusion:A surgical margin >10 mm can improve the relapse free survival rate, but it will increase the incidence of postoperative liver dysfunction.

Objective To analyze the characteristics of the crown-root ratios of the anterior teeth in subjects with different periodontal phenotypes in healthy population.Methods A total of 100 periodontally healthy young volunteers were selected,there were 53 females and 47 males,totaling 594 anterior teeth were included in the study.The periodontal probe method was used to determine the periodontal phenotypes of different tooth positions,with 108 cases of thick gingival type and 90 cases of thin gingival type in mesial incisors;95 teeth of thick gingival type and 103 teeth of thin gingival type in lateral incisors,and 98 teeth of thick gingival type and 100 teeth of thin gingival type in cuspids.Panoramic radiographs were taken,crown length and root length of upper anterior teeth were calculated,and crown-root ratio was calculated,to compare and analyze the differences between the results of the two groups.Results The crown-to-root ratio in thin gingival group of mesial incisors and lateral incisors were higher than those in thick gingival group,and the root length was smaller than thick gingival group.The difference was statistically significant(P＜0.05).The keratinized gingival width of thin gingival group was less than that of thick gingival group,and the difference was statistically significant(P＜0.05).Conclusion The relatively high crown-to-root ratio of mesial incisors and lateral incisors in patients with thin gingival phenotypes and the lesser width of keratinized gingiva in thin gingival phenotypes than thick gingival phenotypes.and risk assessment should be taken into account in the restorative system as well as in the orthodontic design of the anterior tooth movement.

Objective:To explore the method of early prediction of the risk of limb infection in patients bitten by trimersurus mucrosquamatus snake. Methods:Totally 108 inpatients with limbs bitten by trimersurus mucrosquamatus snake in Chongqing Emergency Medical Center from January 2019 to October 2020 were respectively collected. They were divided into the infection group (23 cases) and non infection group (85 cases) according to whether they had secondary infection in the course of the disease. The clinical characteristics and serum indexes before admission were compared between the two groups to screen out the risk factors of infection. By combining all the above methods, the risk factor score was screened out; and the prediction model was constructed according to the snake bite severity score (SSS) and appearance score. The differences of the three prediction models between the two groups of patients were compared, and the predictive value of the three prediction models for the risk of limb infection in patients bitten by trimersurus mucrosquamatus snake was evaluated through the receiver operating characteristic (ROC) curve. Results:There were significant differences in clinical characteristics and serum indexes before admission, injury time, hand and foot finger injury, edema score, tension blister, subcutaneous hemorrhage and admission platelet count between the two groups ( P<0.05). The scores of the three predictive models differed between the two groups ( P<0.05). The ROC curve was used to evaluate the predictive value of the three models for the risk of infection in the course of the disease. The predictive AUC value of the risk factors score was 0.830 (95% CI: 0.635-0.850), the cutoff value was 2.5, the sensitivity was 0.870 and the specificity was 0.671, which was the best in the three prediction models. Conclusions:The prediction model based on the risk factors can effectively predict the infection risk of snake bite patients. It indicates that the infection risk is high when the score of risk factors ≥3 points, which can be used as the basis for guiding clinical treatment plan and is worthy of promotion.

Objective    To evaluate short-term clinical outcomes of skeletonized bilateral internal mammary artery (sBIMA) in coronary artery bypass grafting (CABG). Methods    The clinical data of 62 patients (54 males and 8 females with an average age of 56.8±6.0 years) undergoing isolated CABG using sBIMA in our hospital from October 2016 to May 2017 were retrospectively analyzed. The coronary graft flow, perioperative clinical outcomes and CT results were reviewed. Results    All the operations were carried out under extracorporeal circulation. Anastomosis of 124 internal mammary arteries was performed and 116 great saphenous veins were used simultaneously with an average anastomosis site of 4.5±0.8 for each patient. The cardiopulmonary bypass time was 116.4±22.9 min, aortic clamping time was 83.0±18.3 min, mechanical ventilation time was 20.8±21.3 h and ICU stay was 2.7±1.7 d. The graft flow of left internal mammary artery (LIMA), right internal mammary artery (RIMA) and great saphenous vein were 28.8±12.4 mL/min, 32.8±13.8 mL/min and 41.5±21.5 mL/min, respectively. There was no significant difference in the graft flow between LIMA and RIMA (P=0.112). There was no perioperative mortality, myocardial infarction or cerebrovascular accident. Only one male patient suffered sternal complication and poor wound healing and then received debridement as well as suturing. Coronary CT angiography showed that distal anastomosis of 7 vein grafts and 5 artery grafts was demonstrated shallow and 1 vein graft was undemonstrated, suggesting occlusion. Conclusion    CABG with sBIMA is a safe and reliable technique with excellent early results.

Objective:To analyze the epidemiological characteristics of the cases firstly reported as "asymptomatic infection of COVID-19" in Guangdong province.Methods:The follow-up observation method was used to continuously track and observe the cases firstly reported as "asymptomatic patients with COVID-19" in Guangdong province from January 14 to March 31, 2020. The epidemiological data of the cases were collected to analyze their epidemiological characteristics, outcome and influencing factors.Results:From January 14 to March 31, 2020, a total of 325 cases were firstly reported as "asymptomatic infections of COVID-19" in Guangdong province. The epidemic curve of asymptomatic infection cases was similar to that of confirmed cases, and it had two peaks. The first peak was from January 27 to February 5, and the second peak was from March 17 to March 26. Of the 325 cases, 184 (56.6%) were subsequently converted to confirmed cases. These cases were defined as incubation period asymptomatic infection cases. The age median of the cases was 40 years, and 93.5% (172/184) of the cases showed symptoms within 3 days after the first positive nucleic acid tests were conducted, and 141 (43.4%) of the 325 cases remained asymptomatic status until they were cured and discharged. They were inapparent infection cases, accounting for 8.6% (141/1 642) of those diagnosed with COVID-19 in Guangdong province during the same period. The age median of inapparent infection cases was 27 years. The median of the interval between the first positive nucleic acid test and discharge was 14 days. Up to 90.8% (138/141) of the inapparent infection cases were discharged for centralized medical observation within 28 days. The longest interval between the first positive nucleic acid test and the last positive nucleic acid test was 73 days. The positive rate of nucleic acid test was 0.3% in close contacts of inapparent infection cases and 2.2% in close contacts of incubation period asymptomatic infection cases. There were significant differences in age distribution and source of infection between incubation period asymptomatic infection cases and inapparent infection cases ( P<0.05). Old age was the risk factor for the conversion of firstly reported asymptomatic infection cases to confirmed cases. Compared with the 0-19-year-old group, The patients aged 40-59 years and 60 years and above were more likely to become confirmed cases. The OR (95 %CI) values were 2.730 (1.380-5.402) and 5.302 (2.199-12.783), and P values were 0.004 and 0.000, respectively. People being infected in China were more likely to become confirmed cases ( OR=7.121, P=0.000). Conclusions:There were asymptomatic infection cases among patients diagnosed with COVID-19. The infectiousness of incubation period asymptomatic infection cases might be stronger than that of inapparent infection cases. The proportion of younger cases among asymptomatic infection cases was higher than that of the confirmed cases. Old age and domestic infection were the risk factors for the conversion of asymptomatic infection cases to confirmed cases, to which more attention should be paid. Further serological investigations are needed to provide a basis for the development of COVID-19 prevention and control strategies.

Objective To analyze the clinical courses and outcomes of COVID-19 cases and the influencing factors in Guangdong province and provide basis for the formulation or adjustment of medical care and epidemic control strategy for COVID-19. Methods We collected demographic data, medical histories, clinical courses and outcomes of 1 350 COVID-19 patients reported in Guangdong as of 4 March 2020 via epidemiological investigation and process tracking. Disease severity and clinical course characteristics of the patients and influencing factors of severe illness were analyzed in our study. Results Among 1 350 cases of COVID-19 cases in Guangdong, 72 (5.3%) and 1049 (77.7%) were mild and ordinary cases, 164 (12.1%) were severe cases, 58 (4.3%) were critical cases and 7 (0.5%) were fatal. The median duration of illness were 23 days ( P 25 - P 75 : 18-31 days) and the median length of hospitalization were 20 days ( P 25 - P 75 : 15-27 days). For severe cases, the median time of showing severe manifestations was on the 12th day after onset ( P 25 - P 75 : 9th to 15th days), and the median time of severe manifestation lasted for 8 days P 25 - P 75 : 4-14 days). Among 1 066 discharged/fetal cases, 36.4% (36/99) and 1.0% (1/99) of the mild cases developed to ordinary cases and severe cases respectively after admission; and 5.2% (50/968) and 0.6% (6/968) of the ordinary cases developed to severe cases, and critical cases respectively after admission. In severe cases, 11.4% developed to critical cases (10/88). The influencing factors for severe illness or worse included male (a HR =1.87, 95% CI : 1.43-2.46), older age (a HR =1.67, 95% CI : 1.51-1.85), seeking medical care on day 2-3 after onset (a HR =1.73, 95% CI : 1.20-2.50) pre-existing diabetes (a HR =1.75, 95% CI : 1.12-2.73) and hypertension (a HR =1.49, 95% CI : 1.06-2.09). Conclusions The course of illness and length of hospitalization of COVID-19 cases were generally long and associated with severity of disease clinical outcomes. The severe cases were mainly occurred in populations at high risk. In the epidemic period, classified management of COVID-19 cases should be promoted according to needs for control and prevention of isolation and treatment for the purpose of rational allocation of medical resources.