BACKGROUND:Periodontitis is an inflammatory and destructive disease with plaque biofilm as the main pathogenic material,which occurs in the gingiva,periodontal ligament,alveolar bone and cementum.The antigen of bacterial complex and its secreted toxin and enzyme directly lead to the destruction of periodontal tissue and trigger the host's immune response,causing indirect damage to the body tissue.Silence information regulatory factors(Sirtuins,SIRTs)play an important role in anti-aging,anti-oxidative stress,regulating inflammation,and mediating autophagy,and are closely related to the occurrence and development of periodontitis. OBJECTIVE:To review the research status of Sirtuins in periodontitis. METHODS:The first author used the computer to search the relevant research regarding the role of Sirtuins in periodontitis in PubMed,Web of Scene,CNKI and WanFang databases.The key words were"Sirtuins,Sirtuin1-7,periodontitis"in English and Chinese.After literature screening,57 articles were included for review and analysis. RESULTS AND CONCLUSION:SIRT1,SIRT2,SIRT3,and SIRT6 participate in regulating the occurrence and development of periodontitis.Inhibition of SIRT1 expression may be the target of periodontitis treatment,while overexpression of SIRT1 can inhibit periodontitis and protect periodontal tissue.The activator of SIRT1 can reduce the inflammation of periodontal tissue and improve the systemic pathological changes caused by periodontitis.SIRT2 is involved in nicotinamide phosphoribosyltransferase-mediated periodontal inflammation and plays a role in the treatment and prognosis of periodontal diseases.SIRT3 can improve age-related periodontal disease.Gastrodin promotes the osteogenic differentiation of periodontal ligament stem cells through the up-regulation of SIRT3.The activator of SIRT3 reduces the damage of periodontitis to periodontal and renal tissues by regulating the level of autophagy in the cells.SIRT6 can inhibit the inflammatory reaction of periodontal tissue and inhibit the differentiation and mineralization of cementoblasts.SIRT6 is beneficial to the prognosis of periapical periodontitis.The relationship between SIRT4,SIRT5,SIRT7 and periodontitis is rarely reported.

Objective:To investigate the clinical characteristics of children with Kawasaki disease (KD) complicated with atlantoaxial rotatory subluxation (AARS).Methods:Clinical characteristics of 60 AARS patients complicated with KD (the atlantoaxial rotatory subluxation group) and 60 patients with KD only diagnosed (the control group)in the Children′s Hospital of Chongqing Medical University from December 2010 to December 2019 were retrospectively analyzed.Differences between groups were compared by the Chi- square test and the t test. Results:A total of 8 365 KD patients were diagnosed during the study period, involving 60 cases (0.72%) complicated with AARS.which usually occurred in the acute phase with the onset ages of 3 to 6 years ( P<0.001). Initial clinical symptoms of KD complicated with AARS included fever with restricted neck movement (100.00%), neck mass (66.67%), torticollis (21.67%) and neck pain (11.67%). CT or X-ray exa-mination of the neck indicated AARS, with thickening and swelling of the cervical soft tissues in some cases.Compared with those of control group, red, dry, cracked lips ( P=0.01) and cervical lymph node swollen ( P<0.001) were significantly pronounced in KD patients complicated with AARS.The absolute and relative count of neutrophils were significantly higher in KD patients complicated with AARS (all P< 0.05). Cervical soft tissue swelling and thickening in B-ultrasound were more obvious than those in the control group( P<0.05). However, there were no significant differences in coronary artery lesions and the response to intravenous immunoglobulin (IVIG) combined with Aspirin between groups ( P>0.05). Head traction could relieve neck symptoms to a certain extent, but there was no significant difference between groups ( P>0.05). Conclusions:Cervical lymphadenopathy, red, dry, cracked lips, increase of absolute and relative count of neutrophils, and swelling and thicke-ning of cervical soft tissues were the high-risk factors of KD complicated with AARS.The complication of AARS in KD patients did not increase the risk of coronary artery injury and IVIG resistance.IVIG combined with aspirin achieved a good prognosis in the majority of KD patients complicated with AARS.

AIM: In order to bridge the gap between pharmacogenomic research and its clinical application, we propose the concept of genetic electronic identity, named "GeneFace", and developed an electronic information system which integrated "drug-gene" interactions and recommendations for personalized medicine. METHODS: Based on the self-developed Precision Medicine knowledgebase, which concludes drug directions, guidelines or important literatures with high level of evidence, we developed GeneFace with Java-based open-resource application framework Spring Boot, further developed a mobile App with cross-platform framework Uni-APP. RESULTS: The App includes six modules: genetic testing appointment, genetic knowledge introduction, individualized medication advice, medication records, Geneface interpretation, and Precision Medicine knowledgebase. By detecting the genotype of more than 300 gene loci upon first use, users import the results to form a personal "drug-gene identity card". Then scan or enter the drug name in "GeneFace", the App would automatically give corresponding medication recommendations, including: risks for possible adverse drug reactions, risks for reducing the efficacy or even ineffectiveness, and possibility for dose adjustment, etc., which increase the safety of clinical drug use. People can obtain pharmacogenomics knowledge and basic drug information in the "GeneFace" app. CONCLUSION: Development as a digital therapeutic product, the expanded application of GeneFace can rapidly promote clinical applications of basic pharmacogenomics research and significantly improve drug use safety, which creating a new model for accelerating the clinical application of personalized medicine.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

Objective:To explore the related mechanisms of biological root resorption in decidual teeth by studying the biological effect of simulated occlusal force on the periodontal ligament stem cells (PDLSC) at different stages of root absorption.Methods:According to the tooth type and root absorption degree, healthy retained deciduous incisors and healthy first premolars that needed to be removed for orthodontic treatment were collected and divided into three groups with six teeth in each group: the deciduous unabsorbed group (UN group), the absorbed group (R group) and the permanent teeth group (P group). PDLSC was isolated from periodontal ligament and cultured. PDLSC of three groups were loaded with dynamic pressure of 0-45, 0-90, 0-135, 0-180, 0-225 and 0-270 kPa, respectively. The proliferation ability was detected by cell counting kit-8 (CCK-8) technique on day 1 to day 7, respectively. The apoptosis levels of PDLSC after loading with dynamic pressure of 0-45, 0-90, 0-135, 0-180 and 0-225 kPa were observed by the flow cytometry. The changes of microfilaments were observed by fibrous actin (F-actin) staining after the cytokeleton was subjected to dynamic pressure of 0-90 kPa.Results:PDLSC of three groups exhibited various proliferation abilities to dynamic pressure. The A values in the UN group and R group were significantly higher than those in the P group and the difference was statistically significant ( P<0.05). However, there was no significant difference between the UN group and the R group ( P>0.05). The A values of PDLSC in UN group and R group under dynamic pressures of 0-45, 0-90, 0-135 and 0-180 kPa had no statistical significance compared with the control group unloading dynamic pressure ( P>0.05). However, under 0-225 and 0-270 kPa dynamic pressures, the A values at the day 3 to day 7 were statistically significant ( P<0.05). The A values of PDLSC in P group under 0-45, 0-90, 0-135, 0-180 and 0-225 kPa dynamic pressures for 1 to 7 days were no statistically significant difference compared with the control group ( P>0.05). The A value in P group under the 0-270 kPa was statistically significant only on day 3 (1.386±0.131) and day 5 to day 7 (1.728±0.226, 2.029±0.168 and 2.263±0.210, respectively)( P<0.05). The result of apoptosis showed that the A values of PDLSC in UN group, R group and P group were significantly increased under 0-90, 0-135, 0-180 kPa and above dynamic pressures, respectively ( P<0.05) compared with the control group unloading dynamic pressure. Under 0-90 kPa dynamic pressure, F-actin fluorescence staining samples in three groups all showed green filaments which were arranged along the long axis of the cells in the R group and the P group, while some fibers in the UN group were closely arranged and promoted stress fiber assembly. Conclusions:The biological characteristics of PDLSC at different root absorption stages were changed when they were stimulated by mechanical stress, and PDLSC of the deciduous teeth at the root unabsorption stage were more sensitive to mechanical stress stimulation.

Objective To investigate the epidemiological characteristics and spatial distribution of hepatitis B in children in Kaizhou District of Chongqing from 2018 to 2019, and to provide a theoretical basis for the prevention and control of hepatitis B. Methods The prevalence of hepatitis B in Kaizhou District of Chongqing from 2018 to 2019 was calculated using Excel2003, and the spatial data was processed by SaTScan9.6. Aggregation of incidence of hepatitis B was investigated by calculating Moran^'s I coefficient. Aggregated distribution of the incidence of hepatitis B was explored by local spatial autocorrelation analysis. Results From 2018 to 2019, the cumulative number of hepatitis B in children in Kaizhou District of Chongqing was 86, with an average annual reported incidence rate of 3.01 per 100,000. Among 86 children with hepatitis B, 54 were male and 32 were female, with a male to female ratio of 1.69:1. The incidence rate of hepatitis B in 2019 was lower than that in 2018 ( P<0.05 ). The incidence rate of hepatitis B in males was higher than that in females in each year (P <0.05 ). The incidence rate of hepatitis B among children aged 10 to 14 years old was higher than that of any other age groups ( P<0.05 ). The hepatitis B incidence reported in Chongqing from 2018 to 2019 had spatial aggregation (Moran^'s I=0.4736, P<0.05; Moran^'s I=0.3915, P<0.05). The high-high (H-H) cluster areas of hepatitis B were mainly distributed in Maliu Township, Zishui Township, and Tianhe Town, while the low-low (L-L) cluster areas of hepatitis B were mainly distributed in Zhaojia Street and Changsha Town. Conclusion In 2018-2019, the incidence of hepatitis B among children in Kaizhou District, Chongqing City had a downward trend. The incidence of hepatitis B among males and children aged 10 to 14 years old was relatively high. There was a positive spatial autocorrelation of the incidence. The prevention and treatment of hepatitis B in high-risk population and hot spots should be strengthened.

Objective:To construct an expression system of lentivirus vector encoding epidermal growth factor receptor-specific chimeric antigen receptor (EGFR-CAR) and programmed cell death ligand-1 (PD-L1) antibody.Methods:Human PD-L1-Fc protein was used to immunize BALB/c mice. Cell-fusion and subcloning were performed to screen stable hybridoma strains with high secretion of PD-L1-specific antibodies, which were identified by both ELISA and Western blot. The activity of the antibodies in blocking the binding of programmed cell death-1 (PD-1) to PD-L1 was determined by fluorescence-activated cell sorting (FACS). Antibody affinity was analyzed by Fortebio Octet96. A single-chain variable fragment (scFv) was further constructed after antibody full-length sequencing and humanization using CDR grafting method. Meanwhile, the genes encoding the light and heavy chain variable regions (VL and VH) were cloned from a hybridoma secreting antibody against human EGFR by 5′ RACE technology to construct scFv gene. The expression of scFv was confirmed using pcDNA3.1 vector. EGFR-CAR containing CD137 intracellular function domain and PD-L1-scFv was ligated using 2A gene. The synthetic single molecule was cloned into pLVX-EF1a-IRES-ZsGreen1 lentivirus expression vector, and then transfected into 293T cells using Lenti-X Packaging Single Shots (VSV-G) to prepare infectious virus. Expression of CAR on cell surface and the soluble form of PD-L1-scFv in the supernatant of transfected 293V cells were detected by FACS and ELISA.Results:A PD-L1 antibody named 11E3 with high ligand-receptor blocking performance was obtained. The humanized antibody showed a stable affinity (2.67×10 -10 mol/L) after directly grafting the mouse CDRs (CDR1, CDR2 and CDR3) to human frameworks. EGFR-scFv was effectively expressed in a form of Fc-fusion. Secretory CAR (CTZ0431-1) and membrane CAR (CTZ0431-2) expression plasmids were constructed using lentivirus vector containing EGFR-CAR and PD-L1-scFv. The infection efficiency in 293V cells was around 10%. EGFR-scFv on the cell membranes and PD-L1-scfv in the culture supernatants were detected after 293V cells were infected with CTZ0431-1. EGFR-scFv and PD-L1-scfv were expressed on the cell membranes of 293V cells infected with CTZ0431-2. The expression rate of CAR in LV-CART46407-1-transfected activated T cells was 39.3%. Conclusions:The lentivirus vectors co-expressing EGFR-CAR with moderate binding affinity and PD-L1-scFv with high binding affinity were successful constructed, which provided an essential tool for investing EGFR- and PD-L1 double targeted CAR-T cell therapy against solid tumor.

Objective To compare a novel mirror-overlap method with the traditional manual measurement and the subjective assessment in assessing breast symmetry after oncoplastic surgery.Methods 59 patients with breast cancer who underwent conservation/reconstruction surgery were recruited.The post-operative assessment for breast symmetry was conducted using manual measurement,subjective assessment by the patient,their family member and a nurse,and the mirror-overlap method respectively.The latter method involved using the Photoshop to assess the area differences in breast outlines and shadows created by a flashlight when bilateral images were overlapped in the axis of midline.Results The distance differences between bilateral breasts measured using manual method were negatively correlated with symmetric coefficients in the mirror-overlap method (P＜0.05).There was a positive correlation between the average scores in the subjective assessment and symmetric coefficients of mirror-overlap method (P＜0.05).Conclusion The mirror-overlap method is an easy,feasible and cheap method which collects 3D breast information and provides an effective approach to assess breast symmetry after oncoplastic surgery.

Hepatoid adenocarcinoma (HAC) of the gallbladder is a variant of extrahepatic adenocarcinoma with hepatic differentiation.With similar clinicopathological presentation,the main differential diagnoses are hepatocellular carcinoma (HCC) and gallbladder carcinoma (GBC).At present,HAC of the gallbladder have only been reported in a few researches.This article will summarize comprehensive researches on the histological origin,clinical characteristics,histopathological and immunohistochemical characteristics,differential diagnosis,therapy and prognosis of HAC of the gallbladder.

Objective To understand the risk factors for poor prognosis of severe adenovirus pneumonia (SAP)in children,and provide guidance for clinical diagnosis and prognosis.Methods Clinical data of 91 hospitalized children who diagnosed with SAP in Chongqing Children’s Hospital of Chongqing Medical University between January 2012 and January 2014 were analyzed retrospectively.Results Of 91 SAP children,23 (25.27%)had poor prognosis. Univariate analysis showed that risk factors for poor prognosis of SAP were age of onset,congenital heart disease and other serious underlying diseases,mechanical ventilation therapy,acute respiratory distress syndrome (ARDS), atelectasis and other serious radiological changes,and emergence of two and more extra-pulmonary complications (all P <0.05).Multivariate regression analysis showed that congenital heart disease and other serious underlying diseases,and emergence of two and more extra-pulmonary complications were independent risk factors for poor prognosis of SAP (all P <0.05).Conclusion Congenital heart disease and other serious underlying diseases,emer-gence of two and more extra-pulmonary complications are independent risk factors for poor prognosis of SAP,active intervention should be conducted during the process of clinical diagnosis and treatment,so as to improve the prognosis.